Eagle syndrome

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Classification according to ICD-10
M77.9 Enthesopathy , unspecified
- bone spur
ICD-10 online (WHO version 2019)
Eagle syndrome in the X-ray image: The very long stylus process or the ossification of the stylohyoid ligament can be clearly seen
Normal-sized stylus processes ( processus styloideus ) on a skull specimen
Extra-long stylus extension on the right, computed tomography

The Eagle syndrome (also stylohyoid syndrome or stylo-kerato-hyoidal syndrome ) is caused by an excessively long (> 30 mm) stylus process ( processus styloideus ) or by calcification of the stylohyoid ligament. The processus styloideus is a bony extension of the temporal bone ( os temporale ) at the base of the skull , which extends downwards like a stylus and merges into the ligamentum stylohyoid . This band of connective tissue in turn ends at the hyoid bone (os hyoideum) and is used to suspend it. The syndrome was first described in 1937 by the US ENT doctor Watt Weems Eagle (* 1898).


The temporal styloid process is elongated in around 4–7% of the population, around 4–10.3% of them have symptoms of Eagle's syndrome. The frequency of ossification of the styloid chain (processus styloideus of the temporal bone, stylohyoid ligament and cornu minus the hyoid bone) varies between 4 and 30%. The syndrome is often overlooked. Possible symptoms are:

The symptoms can be caused by pressure on nerves and nerve branches ( glossopharyngeal nerve , vagus nerve , trigeminal nerve ), pinching of the cervical vessels ( common carotid artery , jugular vein ), irritation of the sympathetic nerves of the arterial sheaths, degenerative changes in the calcified and ossified ligament Proc. styloideus or rheumatic attack ( rheumatoid arthritis ). Dissections of the carotid artery and transient ischemic attacks were also observed.

Epidemiology and cause

It mainly affects women with a ratio of 3: 1 between the ages of 30 and 40. The cause and development of the disease is unclear. A previous trauma is discussed , e.g. B. also in the context of a removal of the tonsils ( tonsillectomy ), a congenital malformation and an ossification of the ligamentum stylohyoid .


In the case of clinical suspicion, the diagnosis can usually be identified by means of X-rays as a visual diagnosis in the orthopantomogram , or it can be made with computed tomography . The ultrasound and magnetic resonance imaging are less suitable methods.


Therapeutically, conservative measures are used with corticoid injections into the tonsil compartment, neuroleptics or, in the case of treatment-refractory complaints , plastic reduction of the styloid process. Simple pain therapy usually fails.


  • K. Prasad et al .: Elongated Styloid Process (Eagle's Syndrome): A Clinical Study. In: J Oral Maxillofac Surg. 60, 2002, pp. 171-175.
  • JS Rechtweg, MK Wax: Eagle's syndrome: a review. In: Am J Otolaryngol. 19 (5), Sep-Oct 1998, pp. 316-321.
  • GR Goldstein, IW Scopp: Radiographic interpretation of calcified stylomandibular and stylohyoid ligaments. In: J Prosthet Dent. 30, 1973, p. 330.
  • WW Eagle: Elongated styloid process, symptoms and treatment. In: Arch Otolaryngol. 67, 1958, pp. 172-176.
  • E. Piehslinger and others: Basics of dental prosthetics. 2002, pp. 162-163.
  • E. Piehslinger et al.: The Eagle Syndrome - A representation based on a case report. In: Z Stomatol. 87/10, pp. 525-530.
  • Hossein Shahoon, Camellia Kianbakht: Symptomatic Elongated Styloid Process or Eagle's Syndrome: A Case Report.
  • Ryan D. Murtagh, Jamie T. Caracciolo, Gaspar Fernandez: CT Findings Associated with Eagle Syndrome.
  • Hakan Demirtaş, Mustafa Kayan, Hasan Rıfat, Koyuncuoğlu Ahmet, Orhan Çelik, Mustafa Kara, Nihat Şengeze: Eagle Syndrome Causing Vascular Compression with Cervical Rotation: Case Report.
  • O. Sveinsson, N. Kostulas, L. Herrman: Internal carotid dissection caused by an elongated styloid process (Eagle syndrome).
  • P. Thoenissen, G. Bittermann, R. Schmelzeisen, T. Oshima, T. Fretwurst: Eagle's syndrome — A non-perceived differential diagnosis of temporomandibular disorder.
  • Suneet Khandelwal, Yajuvender Singh Hada, Ashutosh Harshc: Eagle's syndrome - A case report and review of the literature.
  • MS Babad: Eagle's Syndrome Caused by Traumatic Fracture of a Mineralized Stylohyoid Ligament — Literature Review and a Case Report.

Individual evidence

  1. WW Eagle: Elongated styloid process. In: Archives of Otolaryngology. Chicago, 25, 1937, pp. 584-587.
  2. Tarik Mizziani, Martin Kunkel: The Eagle Syndrome. In: zm. 102, No. 18 A, September 16, 2012, (2296), pp. 36-38. Retrieved January 6, 2015.

Web links