Elongated styloid process syndrome: intraoral versus external approach for styloid surgery

Elongated styloid process is a source of craniofacial and cervical pain. This condition is characterized by a dull, nagging, pharyngeal pain and a palpatory finding in the tonsillar fossa. Radiologic demonstration of styloid elongation is readily made in most instances. The incidence and pathogenesis of the styloid syndrome are discussed and the differential diagnosis detailed. The only effective treatment is surgical shortening of the styloid process. Eight patients undergoing surgery for elongated styloids are reported and the intraoral and external surgical approaches are presented. The external cervical approach is preferred since surgical visualization is optimal and the risk of deep cervical infection is minimal.