Is an elongated stylohyoid process prevalent in the elderly? A radiographic study in a Brazilian population

Elongation and calcification of the stylohyoid ligament complex may be correlated with Eagle's syndrome. The styloid complex pathogenesis is still being debated.

The aim of this study was to investigate the prevalence of stylohyoid ligament complex elongation in panoramic radiographs of 2252 patients in a Brazilian adult, partially edentulous population, of both sexes.

The radiographs, taken in the Semiology Department at the Dental School in Brazil, were randomly selected from January 1997 to December 2000. The stylohyoid ligament complexes were measured from the cranial base up to the osseous tip of each process. Mineralisation of the complex of more than 25 mm in length on the radiograph was considered to be abnormal. The same operator made all the measurements. The lengths of the areas of mineralisation were recorded, and whether the condition was bilateral was noted.

This abnormality was present in both sexes. A calcified complex was found in 451 of the 2252 patients. The majority of these calcified complexes (n = 248; 54.9%) were bilateral. Three hundred and fifty-six (39.5%) of them were longer than 25 mm (and so were abnormal), and the length varied from 26.1 to 65 mm. (average length = 27.8 mm). Forty (4.4%) of the abnormalities were longer than 50 mm, and of these 36 (90%) were in the 40-59 year age group. The mean length of a mineralised stylohyoid ligament complex in patients in the 60-79 year age group was 32.75 mm.

The results suggested that an anatomical variant of the stylohyoid ligament complex was more frequently found in the elderly female population, although this abnormality was present in both sexes. There was a greater tendency for the abnormality to be present in patients between 60 and 79 years of age.