A computed tomography-based morphometric study of the styloid process
Abstract
Background: The styloid process (SP) refers to a cylindrical piece projecting from the inferior of the temporal bone, situated anterior to the stylomastoid foramen. It is an anatomic formation close to major vessels and nerves, and its excessive elongation results in pathologies leading to anatomical disorders, such as Eagle’s syndrome. Several studies have been conducted on SP in relation to its close proximity to vessels and nerves, but there is no study that reveals its distance to important anatomical formations, such as the internal auditory meatus (IAM), carotid canal (CC), cochlea, tegmen tympani (TT) and tragus. In the current study, we aimed to investigate the incidence of Eagle’s syndrome based on morphometric measurements of SP.
Materials and methods: The patient files archived in the Radiology Department of Adiyaman University Training and Research Hospital were retrospectively examined. The study was carried out on the data of patients for whom specialist radiologists found no pathology findings on the computed tomography images. A total of 77 individuals (36 females and 41 males) aged 22 to 54 years were included in the study. The length of SP and its distances to IAM, cochlea, CC, TT and tragus were obtained using computed tomography radiological measurements.
Results: When the individual measurements performed on computed tomography images were evaluated in men and women, no significant difference was found concerning the distance between SP and various anatomic structures in close proximity to SP (p > 0.05). However, there was a statistically significant difference between the genders in length of the right SP (p = 0.003) and left SP (p = 0.006).
Conclusions: This anthropometric study revealed the standard morphometric measurements of SP. We believe that the data obtained will help clinicians to identify and diagnose pathologies more easily.
Keywords: temporal bonestyloid processmorphometric measurementscomputed tomography
References
- Arifoğlu Y. Her Yönü ile Anatomi İkinci Baskı, İstanbul, İstanbul Tıp Kitapevi. ; 2016: 66–68.
- Arıncı K, Elhan A. Anatomi 1. Cilt. Altıncı Baskı. Ankara, Günes Kitabevi. 2016: 37–42.
- Bozkır MG, Bora H, Dere F. The Evaluation of Elongated Styloid Process in Panoramic Radiographs in Edentulous Patients. Tr J of Medical Sciences. 1999; 29: 481–485.
- Carroll MKO. Calcification in the stylohyoid ligament. Oral Surg Oral Med Oral Pathol. 1984; 58(5): 617–621.
- Chuang WC, Short JH, McKinney AM, et al. Reversible left hemispheric ischemia secondary to carotid compression in Eagle syndrome: surgical and CT angiographic correlation. AJNR Am J Neuroradiol. 2007; 28(1): 143–145.
- Custodio AL, Silva MR, Abreu MH, et al. Styloid Process of the Temporal Bone: Morphometric Analysis and Clinical Implications. Biomed Res Int. 2016; 2016: 8792725.
- 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.
- Faivre A, Abdelfettah Z, Rodriguez S, et al. Neurological picture. Bilateral internal carotid artery dissection due to elongated styloid processes and shaking dancing. J Neurol Neurosurg Psychiatry. 2009; 80(10): 1154–1155.
- Gokce C, Sisman Y, Ertas ET, et al. Prevalence of styloid process elongation on panoramic radiography in the Turkey population from cappadocia region. Eur J Dent. 2008; 2(1): 18–22.
- Jung T, Tschernitschek H, Hippen H, et al. Elongated styloid process: when is it really elongated? Dentomaxillofac Radiol. 2004; 33(2): 119–124.
- Kaufman SM, Elzay RP, Irish EF. Styloid process variation. Radiologic and clinical study. Arch Otolaryngol. 1970; 91(5): 460–463.
- 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.
- Ledesma-Montes C, Hernández-Guerrero JC, Jiménez-Farfán MD. Length of the ossified stylohyoid complex and Eagle syndrome. Eur Arch Otorhinolaryngol. 2018; 275(8): 2095–2100.
- 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.
- Lorman JG, Biggs JR. The Eagle syndrome. AJR Am J Roentgenol. 1983; 140(5): 881–882.
- MacDonald-Jankowski DS. Calcification of the stylohyoid complex in Londoners and Hong Kong Chinese. Dentomaxillofac Radiol. 2001; 30(1): 35–39.
- Moffat DA, Ramsden RT, Shaw HJ. The styloid process syndrome: aetiological factors and surgical management. J Laryngol Otol. 1977; 91(4): 279–294.
- Mortellaro C, Biancucci P, Picciolo G, et al. Eagle's syndrome: importance of a corrected diagnosis and adequate surgical treatment. J Craniofac Surg. 2002; 13(6): 755–758.
- Murtagh RD, Caracciolo JT, Fernandez G. CT findings associated with Eagle syndrome. AJNR Am J Neuroradiol. 2001; 22(7): 1401–1402.
- Nalçacı R, Mısırlıoğlu M. Yaşli Bireylerde Stiloid Proçesin Radyolojik Olarak Değerlendirilmesi. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi. 2006; 3: 1–6.
- 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.
- 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.
- Orhan KS, Güldiken Y, Ural HĠ, et al. Uzamış stiloid proçes (Eagle‟s sendromu): olgu sunumu. Ağrı. 2005; 17: 23–25.
- Patil S, Ghosh S, Vasudeva N. Morphometric study of the styloid process of temporal bone. J Clin Diagn Res. 2014; 8(9): AC04–AC06.
- Rizzatti-Barbosa CM, Ribeiro MC, Silva-Concilio LR, et al. Is an elongated stylohyoid process prevalent in the elderly? A radiographic study in a Brazilian population. Gerodontology. 2005; 22(2): 112–115.
- 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.
- Vieira EM, Guedes OA, Morais SDe, et al. Prevalence of Elongated Styloid Process in a Central Brazilian Population. J Clin Diagn Res. 2015; 9(9): ZC90–ZC92.