Abstract:
Ossification of stylohyoid chain corresponds to the ossification of stylohyoid ligament that can vary from thin short to thick long ossification and can be associated with other calcifications. We report in this case a bilateral non painful complete ossification of the stylohyoid complex extended to the thyrohyoidien ligament.
Key clinical message: Ossification and elongation of the stylohyoid chain can cause neck and facial symptoms, known as Eagle’s syndrome. Nonetheless, a bilateral ossified and elongated stylohyoid chain associated with ossification of the thyro-hyoid ligament may be not painful.
Keywords: stylohyoid ligament, eagle syndrome, tyro-hyoid ligament, styloid chain, pseudarthroses
A 53-year-old man consulted the dental medicine department for a dental check up. A routine conventional dental radiographic exam was performed and showed bilateral ossification of the stylohyoid complex (figure 1), then confirmed by a lateral neck x-ray (figure 2) that showed ossification of the styloid chain (Styloid Process, stylohyoid ligament and lesser cornua of the hyoid bone) extended to the thyrohyoidien ligament .
The patient had no pain, with very restricted head and neck movements.
He reported the history of severe cervical trauma caused by a fall down stairs 30 years ago.
CT scans of the neck showed an elongated and heavily ossified styloid process, the stylohyoidien ligament extending to the lesser cornua of the hyoid bone with three pseudarthroses, associated with a bilateral ossification of the thyrohyoid ligaments (figure 3).
Usually , the mineralization of the stylohoid ligament complex cause oro-facial pain defining the Eagle’s syndrome [1,2], however it can be non painful and discovered incidentally as in our case. A previous cervical trauma or surgery has been frequently reported as a the main cause [2].
[1] Chebbi R et al. Elongated styloid process as a cause of facial pain joint bone spine. 2014 Jul;81(4):368. doi: 10.1016/j.jbspin.2014.03.007.
[2] Y. Sudrat et al. Eagle’s syndrome: a case report with multiples calcifications. Med Buccale Chir Buccale 2008; 14 : 97-102.