Entrapment of the glossopharyngeal nerve in patients with Eagle syndrome

Surgical technique and outcomes in a series of 5 patients: Clinical article

John H. Shin, Sebastian R. Herrera, Paula Eboli, Sabri Aydin, Emad N. Eskandar, Konstantin V. Slavin

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Object. Eagle syndrome is characterized by unilateral pain in the oropharynx, face, and earlobe, and is caused by an elongated styloid process or ossification of the stylohyoid ligament with associated compression of the glossopharyngeal nerve. The pain syndrome may be successfully treated with surgical intervention that involves resection of the styloid process. Although nerve decompression is routinely considered a neurosurgical intervention, Eagle syndrome and its treatment are not sufficiently examined in the neurosurgical literature. Methods. A review was performed of cases of Eagle syndrome treated in the Department of Neurosurgery at the University of Illinois at Chicago Medical Center over the last 7 years. The clinical characteristics, radiographic imaging, operative indications, procedural details, surgical morbidity, and clinical outcomes were collected and analyzed. Results. Of the many patients with facial pain treated between 2001 and 2007, 7 were diagnosed with Eagle syndrome, and 5 of these patients underwent resection of the elongated styloid process. There were 4 women and 1 man, ranging in age from 20 to 68 years (mean 43 years). The average duration of disease was 11 years. In all patients, a preoperative workup revealed unilateral or bilateral elongation of the styloid process. All patients underwent resection of the styloid process on the symptomatic side using a lateral transcutaneous approach. There were no surgical complications. All patients experienced pain relief immediately after the operation. At the latest follow-up (average 46 months, range 7 months to 7.5 years) all but 1 patient maintained complete pain relief. In 1 patient, the pain recurred 12 months postoperatively and additional interventions were required. Conclusions. Eagle syndrome may be considered an entrapment syndrome of the glossopharyngeal nerve. It is a distinct clinical entity that should be considered when evaluating patients referred for glossopharyngeal neuralgia. The authors' experience indicates that patients with Eagle syndrome may be successfully treated using open resection of the elongated styloid process, which appears to be both safe and effective in terms of long-lasting pain relief.

Original languageEnglish (US)
Pages (from-to)1226-1230
Number of pages5
JournalJournal of Neurosurgery
Volume111
Issue number6
DOIs
StatePublished - Dec 1 2009
Externally publishedYes

Fingerprint

Glossopharyngeal Nerve
Pain
Glossopharyngeal Nerve Diseases
Eagle syndrome
Facial Pain
Oropharynx
Neurosurgery
Decompression
Ligaments
Osteogenesis
Morbidity

Keywords

  • Eagle syndrome
  • Glossopharyngeal neuralgia
  • Styloid process

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Entrapment of the glossopharyngeal nerve in patients with Eagle syndrome : Surgical technique and outcomes in a series of 5 patients: Clinical article. / Shin, John H.; Herrera, Sebastian R.; Eboli, Paula; Aydin, Sabri; Eskandar, Emad N.; Slavin, Konstantin V.

In: Journal of Neurosurgery, Vol. 111, No. 6, 01.12.2009, p. 1226-1230.

Research output: Contribution to journalArticle

Shin, John H. ; Herrera, Sebastian R. ; Eboli, Paula ; Aydin, Sabri ; Eskandar, Emad N. ; Slavin, Konstantin V. / Entrapment of the glossopharyngeal nerve in patients with Eagle syndrome : Surgical technique and outcomes in a series of 5 patients: Clinical article. In: Journal of Neurosurgery. 2009 ; Vol. 111, No. 6. pp. 1226-1230.
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abstract = "Object. Eagle syndrome is characterized by unilateral pain in the oropharynx, face, and earlobe, and is caused by an elongated styloid process or ossification of the stylohyoid ligament with associated compression of the glossopharyngeal nerve. The pain syndrome may be successfully treated with surgical intervention that involves resection of the styloid process. Although nerve decompression is routinely considered a neurosurgical intervention, Eagle syndrome and its treatment are not sufficiently examined in the neurosurgical literature. Methods. A review was performed of cases of Eagle syndrome treated in the Department of Neurosurgery at the University of Illinois at Chicago Medical Center over the last 7 years. The clinical characteristics, radiographic imaging, operative indications, procedural details, surgical morbidity, and clinical outcomes were collected and analyzed. Results. Of the many patients with facial pain treated between 2001 and 2007, 7 were diagnosed with Eagle syndrome, and 5 of these patients underwent resection of the elongated styloid process. There were 4 women and 1 man, ranging in age from 20 to 68 years (mean 43 years). The average duration of disease was 11 years. In all patients, a preoperative workup revealed unilateral or bilateral elongation of the styloid process. All patients underwent resection of the styloid process on the symptomatic side using a lateral transcutaneous approach. There were no surgical complications. All patients experienced pain relief immediately after the operation. At the latest follow-up (average 46 months, range 7 months to 7.5 years) all but 1 patient maintained complete pain relief. In 1 patient, the pain recurred 12 months postoperatively and additional interventions were required. Conclusions. Eagle syndrome may be considered an entrapment syndrome of the glossopharyngeal nerve. It is a distinct clinical entity that should be considered when evaluating patients referred for glossopharyngeal neuralgia. The authors' experience indicates that patients with Eagle syndrome may be successfully treated using open resection of the elongated styloid process, which appears to be both safe and effective in terms of long-lasting pain relief.",
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