Elongated styloid process: is it a pathologic condition?

Area of Science:

• Dentistry
• Radiology
• Anatomy

Background:

• The stylohyoid complex, comprising the styloid process and the hyoid bone, can exhibit elongation.
• Elongated stylohyoid process (ESP) is often identified on panoramic radiographs, but its clinical significance remains debated.

Purpose of the Study:

• To evaluate the length, morphology, and calcification patterns of the elongated stylohyoid process (ESP) on panoramic radiographs.
• To investigate potential clinical symptoms associated with ESP.
• To determine if ESP represents a pathologic condition or a physiologic phenomenon.

Main Methods:

• Evaluation of 207 stylohyoid complexes on panoramic radiographs, assessing length, radiographic appearance, and calcification patterns.
• Classification into ESP (>= 30 mm) and normal (< 30 mm) groups based on length.
• Clinical symptom assessment via questionnaires and examinations, with statistical analysis using Kolmogorov-Smirnov, Mann-Whitney U, and Spearman correlation tests.

Main Results:

• The average stylohyoid complex length was 31.7 mm, with a median of 30.0 mm.
• Continuous morphology and calcified outline were the most frequent patterns in both ESP and normal groups.
• No clinical symptoms were detected in relation to the elongated stylohyoid process.

Conclusions:

• Classification based solely on radiographic length may be inaccurate.
• The similar radiographic appearance and absence of symptoms suggest ESP is a physiologic variation.
• The correlation between increased complex length and age supports its classification as a normal developmental or aging phenomenon.