open access

Vol 77, No 1 (2018)
ORIGINAL ARTICLES
Published online: 2017-06-20
Submitted: 2017-04-21
Accepted: 2017-05-31
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Morphological assessment of the stylohyoid complex variations with cone beam computed tomography in a Turkish population

C. Buyuk, K. Gunduz, H. Avsever
DOI: 10.5603/FM.a2017.0061
·
Pubmed: 28653301
·
Folia Morphol 2018;77(1):79-89.

open access

Vol 77, No 1 (2018)
ORIGINAL ARTICLES
Published online: 2017-06-20
Submitted: 2017-04-21
Accepted: 2017-05-31

Abstract

Background: The aim of this investigation was to evaluate the length, thickness, sagittal and transverse angulations and the morphological variations of the stylohyoid complex (SHC), to assess their probable associations with age and gender, and to investigate the prevalence of it in a wide range of a Turkish sub-population by using cone beam computed tomography (CBCT).

Materials and methods: The CBCT images of the 1000 patients were evaluated retrospectively. The length, thickness, sagittal and transverse angulations, morphological variations and ossification degrees of SHC were evaluated on multiplanar reconstructions (MPR) adnd three-dimensional (3D) volume rendering (3DVR) images. The data were analysed statistically by using nonparametric tests, Pearson’s correlation coefficient, Student’s t test, c2 test and one-way ANOVA. Statistical significance was considered at p < 0.05.

Results: It was determined that 684 (34.2%) of all 2000 SHCs were elongated (> 35 mm). The mean sagittal angle value was measured to be 72.24° and the mean transverse angle value was 70.81°. Scalariform shape, elongated type and nodular calcification pattern have the highest mean age values between the morphological groups, respectively. Calcified outline was the most prevalent calcification pattern in males. There was no correlation between length and the calcification pattern groups while scalariform shape and pseudoarticular type were the longest variations.

Conclusions: We observed that as the anterior sagittal angle gets wider, SHC tends to get longer. The most observed morphological variations were linear shape, elongated type and calcified outline pattern. Detailed studies on the classification will contribute to the literature. (Folia Morphol 2018; 77, 1: 79–89)  

Abstract

Background: The aim of this investigation was to evaluate the length, thickness, sagittal and transverse angulations and the morphological variations of the stylohyoid complex (SHC), to assess their probable associations with age and gender, and to investigate the prevalence of it in a wide range of a Turkish sub-population by using cone beam computed tomography (CBCT).

Materials and methods: The CBCT images of the 1000 patients were evaluated retrospectively. The length, thickness, sagittal and transverse angulations, morphological variations and ossification degrees of SHC were evaluated on multiplanar reconstructions (MPR) adnd three-dimensional (3D) volume rendering (3DVR) images. The data were analysed statistically by using nonparametric tests, Pearson’s correlation coefficient, Student’s t test, c2 test and one-way ANOVA. Statistical significance was considered at p < 0.05.

Results: It was determined that 684 (34.2%) of all 2000 SHCs were elongated (> 35 mm). The mean sagittal angle value was measured to be 72.24° and the mean transverse angle value was 70.81°. Scalariform shape, elongated type and nodular calcification pattern have the highest mean age values between the morphological groups, respectively. Calcified outline was the most prevalent calcification pattern in males. There was no correlation between length and the calcification pattern groups while scalariform shape and pseudoarticular type were the longest variations.

Conclusions: We observed that as the anterior sagittal angle gets wider, SHC tends to get longer. The most observed morphological variations were linear shape, elongated type and calcified outline pattern. Detailed studies on the classification will contribute to the literature. (Folia Morphol 2018; 77, 1: 79–89)  

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Keywords

styloid, temporal bone, morphology, anatomical variations, ossification, eagle syndrome, cone beam computed tomography

About this article
Title

Morphological assessment of the stylohyoid complex variations with cone beam computed tomography in a Turkish population

Journal

Folia Morphologica

Issue

Vol 77, No 1 (2018)

Pages

79-89

Published online

2017-06-20

DOI

10.5603/FM.a2017.0061

Pubmed

28653301

Bibliographic record

Folia Morphol 2018;77(1):79-89.

Keywords

styloid
temporal bone
morphology
anatomical variations
ossification
eagle syndrome
cone beam computed tomography

Authors

C. Buyuk
K. Gunduz
H. Avsever

References (41)
  1. Andrei F, Motoc AG, Didilescu AC, et al. A 3D cone beam computed tomography study of the styloid process of the temporal bone. Folia Morphol. 2013; 72(1): 29–35.
  2. Başekim CC, Mutlu H, Güngör A, et al. Evaluation of styloid process by three-dimensional computed tomography. Eur Radiol. 2005; 15(1): 134–139.
  3. Camarda AJ, Deschamps C, Forest D, et al. I. Stylohyoid chain ossification: a discussion of etiology. Oral Surg Oral Med Oral Pathol. 1989; 67(5): 508–514.
  4. Carroll O. Calcification in the stylohyoid ligament. Oral Surg Oral Med Oral Pathol. 1984; 58(5): 617–621.
  5. Centurion BS, Imada TSN, Pagin O, et al. How to assess tonsilloliths and styloid chain ossifications on cone beam computed tomography images. Oral Dis. 2013; 19(5): 473–478.
  6. Eagle WW. Elongated styloid processes: report of two cases. Arch Otolaryngol. 1937; 25(5): 584–587.
  7. Eagle WW. Elongated styloid process; further observations and a new syndrome. Arch Otolaryngol. 1948; 47(5): 630–640.
  8. Eagle WW. Symptomatic elongated styloid process; report of two cases of styloid process-carotid artery syndrome with operation. Arch Otolaryngol. 1949; 49(5): 490–503.
  9. Ferrario VF, Sigurtá D, Daddona A, et al. Calcification of the stylohyoid ligament: incidence and morphoquantitative evaluations. Oral Surg Oral Med Oral Pathol. 1990; 69(4): 524–529.
  10. Fini G, Gasparini G, Filippini F, et al. The long styloid process syndrome or Eagle's syndrome. J Craniomaxillofac Surg. 2000; 28(2): 123–127.
  11. Fusco DJ, Asteraki S, Spetzler RF. Eagle's syndrome: embryology, anatomy, and clinical management. Acta Neurochir (Wien). 2012; 154(7): 1119–1126.
  12. Gayathri G, Elavenil P, Sasikala B, et al. 'Stylo-mandibular complex' fracture from a maxillofacial surgeon's perspective--review of the literature and proposal of a management algorithm. Int J Oral Maxillofac Surg. 2016; 45(3): 297–303.
  13. Gokce C, Sisman Y, Sipahioglu M. Styloid process elongation or Eagle’s syndrome: is there any role for ectopic calcification? Eur J Dent. 2008; 2: 224–228.
  14. Gözil R, Yener N, Calgüner E, et al. Morphological characteristics of styloid process evaluated by computerized axial tomography. Ann Anat. 2001; 183(6): 527–535.
  15. Ilgüy M, Ilgüy D, Güler N, et al. Incidence of the type and calcification patterns in patients with elongated styloid process. J Int Med Res. 2005; 33(1): 96–102.
  16. Ilgüy D, Ilgüy M, Fişekçioğlu E, et al. Assessment of the stylohyoid complex with cone beam computed tomography. Iran J Radiol. 2012; 10(1): 21–26.
  17. Jung T, Tschernitschek H, Hippen H, et al. Elongated styloid process: when is it really elongated? Dentomaxillofac Radiol. 2004; 33(2): 119–124.
  18. Kaufman SM, Elzay RP, Irish EF. Styloid process variation. Radiologic and clinical study. Arch Otolaryngol. 1970; 91(5): 460–463.
  19. Kent DT, Rath TJ, Snyderman C. Conventional and 3-dimensional computerized tomography in Eagle's syndrome, glossopharyngeal neuralgia, and asymptomatic controls. Otolaryngol Head Neck Surg. 2015; 153(1): 41–47.
  20. Kursoglu P, Unalan F, Erdem T. Radiological evaluation of the styloid process in young adults resident in Turkey's Yeditepe University faculty of dentistry. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 100(4): 491–494.
  21. Langlais RP, Miles DA, Van Dis ML. Elongated and mineralized stylohyoid ligament complex: a proposed classification and report of a case of Eagle's syndrome. Oral Surg Oral Med Oral Pathol. 1986; 61(5): 527–532.
  22. Lengelé BG, Dhem AJ. Length of the styloid process of the temporal bone. Arch Otolaryngol Head Neck Surg. 1988; 114(9): 1003–1006.
  23. Monsour PA, Young WG. Variability of the styloid process and stylohyoid ligament in panoramic radiographs. Oral Surg Oral Med Oral Pathol. 1986; 61(5): 522–526.
  24. Natsis K, Repousi E, Noussios G, et al. The styloid process in a Greek population: an anatomical study with clinical implications. Anat Sci Int. 2015; 90(2): 67–74.
  25. Okabe S, Morimoto Y, Ansai T, et al. Clinical significance and variation of the advanced calcified stylohyoid complex detected by panoramic radiographs among 80-year-old subjects. Dentomaxillofac Radiol. 2006; 35(3): 191–199.
  26. Omnell KA, Gandhi C, Omnell ML. Ossification of the human stylohyoid ligament: a longitudinal study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 85(2): 226–232.
  27. Onbas O, Kantarci M, Murat Karasen R, et al. Angulation, length, and morphology of the styloid process of the temporal bone analyzed by multidetector computed tomography. Acta Radiol. 2005; 46(8): 881–886.
  28. Oztunç H, Evlice B, Tatli U, et al. Cone-beam computed tomographic evaluation of styloid process: a retrospective study of 208 patients with orofacial pain. Head Face Med. 2014; 10: 5.
  29. Palesy P, Murray GM, De Boever J, et al. The involvement of the styloid process in head and neck pain -- a preliminary study. J Oral Rehabil. 2000; 27(4): 275–287.
  30. Patil S, Ghosh S, Vasudeva N. Morphometric study of the styloid process of temporal bone. J Clin Diagn Res. 2014; 8(9): AC04–AC06.
  31. Pereira FL, Filho LI, Pavan AJ, et al. Styloid-stylohyoid syndrome: literature review and case report. J Oral Maxillofac Surg. 2007; 65(7): 1346–1353.
  32. Petrović S, Jovanović I, Ugrenović S, et al. Morphometric analysis of the stylohyoid complex. Surg Radiol Anat. 2017; 39(5): 525–534.
  33. Ramadan SU, Gokharman D, Tunçbilek I, et al. Assessment of the stylohoid chain by 3D-CT. Surg Radiol Anat. 2007; 29(7): 583–588.
  34. Ramadan SU, Gökharman D, Koşar P, et al. The stylohyoid chain: CT imaging. Eur J Radiol. 2010; 75(3): 346–351.
  35. Reddy RS, Kiran CS, Madhavi NS, et al. Prevalence of elongation and calcification patterns of elongated styloid process in south India. J Clin Exp Dent. 2013: e30–5.
  36. Sancio-Gonçalves FC, de Abreu MH, Netto Soares JM, et al. Stylohyoid complex ossification in temporomandibular disorder: a case-control study. J Prosthet Dent. 2013; 109(2): 79–82.
  37. Shaik MA, Kaleem SM, Wahab A, et al. Prevalence of elongated styloid process in Saudi population of Aseer region. Eur J Dent. 2013; 7(4): 449–454.
  38. Stafne EC, Hollinshead WH. Roentgenographic observations on the stylohyoid chain. Oral Surg Oral Med Oral Pathol. 1962; 15: 1195–1200.
  39. Steinmann EP. Styloid syndrome in absence of an elongated process. Acta Otolaryngol. 1968; 66(4): 347–356.
  40. Vadgaonkar R, Murlimanju BV, Prabhu LV, et al. Morphological study of styloid process of the temporal bone and its clinical implications. Anat Cell Biol. 2015; 48(3): 195–200.
  41. Vougiouklakis T. Overview of the ossified stylohyoid ligament based in more than 1200 forensic autopsies. J Clin Forensic Med. 2006; 13(5): 268–270.

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