Supra Digastric Muscles Approach for Styloid Process Resection.

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.