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Supra Digastric Muscles Approach for Styloid Process Resection.

Shigeomi Yokoya1

  • 1Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Ritto, Shiga, Japan.

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|September 2, 2025
PubMed
Summary

Eagle syndrome requires precise surgical approaches. A modified transcervical resection using the supra digastric muscle approach (SDMA) offers a safe and anatomically precise method for styloid process (SP) resection.

Keywords:
elongated styloid processstylocarotid syndromesupra digastric muscle approachtranscervical resection

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Area of Science:

  • Neurosurgery
  • Vascular Surgery
  • Anatomy

Background:

  • Eagle syndrome, encompassing classical styloid and stylocarotid syndromes, presents surgical challenges.
  • Styloid process (SP) resection is crucial, with intraoral approaches suitable for some cases, while others necessitate transcervical resection due to complex anatomy.

Purpose of the Study:

  • To describe a modified transcervical resection technique for SP using the supra digastric muscle approach (SDMA).
  • To emphasize anatomical precision and safety in managing Eagle syndrome, particularly stylocarotid syndrome.

Main Methods:

  • A step-by-step description of the modified transcervical resection using the SDMA.
  • The procedure involves meticulous dissection through a linear skin incision, identifying key anatomical landmarks like the digastric muscles (DMs) and atlas transverse process.
  • A surgical corridor via the supra DM space provides direct access to the SP for amputation near the temporal skull base, performed under microscopic visualization.

Main Results:

  • The technique was applied in a case of acute cerebral infarction caused by left internal carotid artery dissection, where SP elongation necessitated resection to protect a carotid stent.
  • The supra DM approach facilitated precise SP resection with minimal risk to adjacent nerves.
  • The SP was successfully stripped and amputated near the temporal skull base.

Conclusions:

  • The supra digastric muscle approach (SDMA) is a simple, safe, and effective technique for styloid process (SP) resection.
  • This method enhances anatomical precision and significantly minimizes the risk of nerve damage during surgery for Eagle syndrome.