An Abnormally Long Styloid Process Without Stylohyoid Ligament Ossification: Morphological and CT Findings from Two...

The styloid process is a slender, cylindrical bony projection of the temporal bone, showing marked interindividual variability in length, orientation, and degree of ossification. Its abnormal elongation, defined as exceeding 30 mm, is often associated with Eagle's syndrome but may also occur as an incidental anatomical variant.

This study reports two rare cases of abnormally long styloid processes without ossification of the stylohyoid ligament, identified in adult dry skulls from the osteological collection of the "Olga Necrasov" Centre of Anthropological Research, Iași, Romania, and provides morphological and CT-based characterization.

Both skulls were examined macroscopically and by CT, with 3D reconstructions being used for morphometric analysis.

In Case 1, the left SP measured 62 mm, corresponding to Langlais type I elongation, with no evidence of pseudoarticulation or ligamentous ossification. In Case 2, the left SP was elongated to 33 mm and fusiform in shape, while the contralateral (right) SP was completely absent, a highly uncommon anatomical variation scarcely reported in the literature. Both findings were confirmed by CT imaging.

The coexistence shows that the stylohyoid complex cand vary greatly during development. Such findings expand the spectrum of known anatomical variants of the stylohyoid complex and underscore the importance of detailed morphologic and imaging evaluation of the styloid region in both anatomical and clinical contexts.