What Is Eagle Syndrome After Tonsil Surgery?

By ENT Specialist – Dr. Sagar Rajkuwar, Nashik, Maharashtra, India

Clinic Website: www.entspecialistinnashik.com

Table of contents-

• (1)Introduction
• (2)Causes and Symptoms
• (3)Tests and Diagnosis
• (4)Management and Treatment
• (5)Prognosis/Outlook
• (6)Avoidance
• (7)Residing With
• (8)Conclusion

(1)Introduction

When there are unusual structures in your head or neck that cause throat or facial pain, it is referred to as Eagle syndrome. The cause is either an extended styloid process (the bone under your ear) or a stiffened stylohyoid ligament, which is the band of tissue that connects your styloid process to your jaw. If these components press on nearby nerves, you could feel pain. Symptoms can be eliminated by surgery.

What is Eagle syndrome?

The pain in your face, neck, or throat caused by Eagle syndrome is brought on by a stiff stylohyoid ligament or an extended styloid process. The styloid process, which is a little, needlelike bone, is located beneath each ear. The hyoid bone at the front of your neck is connected to your styloid process by the stylohyoid ligament. As with the majority of ligaments, it should be flexible. However, Eagle syndrome frequently results in a hard, bony appearance.

Symptoms arise when the bone or hard ligament puts pressure on surrounding blood vessels or nerves.

How prevalent is Eagle syndrome?

This uncommon pain illness affects only.16% of the general population.

Less than 4% of people have an extended styloid process. The average length of a styloid process is roughly 2.5 cm, which is less than an inch. A prolonged styloid process measures over 3 cm (just over 1 inch). However, only a small proportion of those with an extended styloid process exhibit signs of Eagle syndrome.

Women are three times more likely to develop Eagle syndrome. The majority of individuals are diagnosed in their 30s or 40s.

(2)Causes and Symptoms

What are the signs of Eagle syndrome?

The location of the nerve or blood vessel that interacts with your styloid process or stylohyoid ligament determines the symptoms.

Symptoms include:

• Pain in the face, neck, or throat (often exacerbated by chewing, yawning, speaking, or turning one’s head).
• Having the sensation that something is lodged in your throat.
• Dysphagia, or trouble swallowing.
• Having tinnitus, or ringing in the ears.
• Headache.
• Dizziness.

The majority of those with Eagle syndrome have an extended styloid process on either side of their head, although the discomfort is often restricted to one side.

How does Eagle syndrome feel?

The symptoms of pain might resemble those of glossopharyngeal neuralgia. The styloid process, which compresses the glossopharyngeal nerve—a significant nerve located deep in the neck—can cause intense or throbbing discomfort in the area of the tonsils or the base of the tongue. The pain could extend to your ear.

The nerve pain linked to Eagle syndrome is characterized by some as recurring, throbbing, and dull.

What are the causes of Eagle syndrome?

When a long styloid process or a hard stylohyoid ligament puts pressure on delicate nerves or blood vessels in your head and neck, symptoms manifest. However, there is still disagreement among experts on the underlying reason for these unusual formations.

Dr. Watt Eagle, who gave the syndrome its name, hypothesized in 1937 that occasionally, the stylohyoid ligament calcifies (transforms into bone) following a tonsillectomy. Additional possible factors include infections, neck trauma, or age-related changes in ligament flexibility.

What are the problems associated with Eagle syndrome?

An elongated styloid process, though uncommon, can compress nearby blood vessels such as your carotid arteries. When this occurs, you may experience pain beneath your eyes or have signs of a transient ischemic attack (TIA) or stroke, such as:

• On one side of your face, there is numbness (hemiparesis).
• Feeling dizzy.
• dim sight.
• Passing out or fainting (syncope).
• changes in your speaking patterns, such as slurring your words.

These symptoms are frequently episodic in Eagle syndrome, which means they will eventually subside. However, they occasionally indicate a medical emergency, such as a cut or injured artery.

If you have signs of a stroke, call 911 (or your local emergency number) or go straight to the emergency room.

(3)Tests and Diagnosis

What methods are used to identify Eagle syndrome?

Your doctor will conduct a physical examination and go over your medical history, including any head and neck injuries or surgeries you may have had. When touching your neck, your doctor may occasionally feel an unusual styloid process. They can also palpate the area of your tonsils inside your mouth and inquire if it hurts.

Anomalies in the stylohyoid ligament or styloid process can be seen in imaging. The tests consist of:

CT scan: A sequence of X-rays are used to photograph your styloid process and stylohyoid ligament. It creates a three-dimensional (3D) representation of these structures, allowing your doctor to determine whether you have an extended styloid process.

CT angiogram: Uses X-rays to capture images of blood arteries. If your provider believes that your carotid arteries are being squeezed by your styloid process or stylohyoid ligament, you may require CT angiography.

What may be confused for Eagle syndrome?

A crucial component of diagnosis is ruling out diseases that might also cause Eagle syndrome symptoms. Your provider can conduct tests to rule out the possibility of:

• Head and neck inflammatory illnesses (sinusitis, tonsillitis, insertion tendinitis).
• Problems with the temporomandibular joint (TMJ).
• Neuralgia of the glossopharyngeal nerve.
• syndrome of myofascial pain.
• Cancer of the head and neck.
• Migraines.
• Issues with the teeth.

(4)Management and Treatment

What are the treatments for Eagle syndrome?

Depending on your situation, your healthcare professional may suggest surgery to reduce the length of your styloid process (styloidectomy) or medicines to help control the discomfort. The course of treatment will depend on the severity of your symptoms and whether you are a good candidate for surgery.

The following are examples of medications:

• Pain relievers (analgesics).
• antidepressants.
• Injections of steroids.
• Injections of lidocaine.
• nonsteroidal anti-inflammatory medications (NSAIDs) that are available over-the-counter (OTC) or by prescription.

Eagle syndrome can be treated by surgery to shorten your styloid process. There are two ways that your surgeon may do a styloidectomy:

Intraoral (transoral): Your surgeon uses your mouth to reach your styloid process. Compared to the extraoral technique, this method is more difficult for your provider to access the area, but it will not leave a scar.

Extraoral (transcervical): The styloid process is reached by your surgeon via a neck incision (cut). With this method, your provider has direct access to the tissue, but the procedure takes longer. Additionally, you will have a scar as a result.

Your provider can tell you which method is best based on your diagnosis.

What are the potential problems with a styloidectomy?

Every procedure has risks. Injury to tissue during surgery might result in scarring and severe infections in your throat, which, if left untreated, can be quite dangerous.

Your risk of such complications can be decreased by seeing a surgeon who has a lot of expertise in performing head and neck procedures.

(5)Prognosis/Outlook

What is the prognosis for Eagle syndrome?

The perspective is positive. About 80% of those who have a styloidectomy no longer have any symptoms. Over-the-counter and prescription pain killers are sufficient for many individuals to manage their pain and suffering.

What are the consequences of leaving Eagle syndrome untreated?

You will continue to have symptoms if you don’t receive treatment. The problem won’t get better by itself.

Nevertheless, it should not be forgotten that having a calcified or extended styloid process does not always indicate Eagle syndrome. Additionally, some people with symptoms of Eagle syndrome and an extended styloid process undergo surgery to shorten the styloid process, but their symptoms do not improve.

Since it might be challenging to determine who will benefit from surgery, it’s crucial to seek treatment from a healthcare professional who is knowledgeable about identifying and treating this illness. Your provider can give you guidance on the available treatments.

(6)Avoidance

Is it possible to prevent Eagle syndrome?

Eagle syndrome cannot be avoided. However, having surgery to shorten your styloid process can get rid of your symptoms for good.

(7)Residing With

What questions should I ask my healthcare provider?

Ask questions such as:

• What probably led to my extended styloid process?
• Is my styloid process pressing on a big nerve or blood vessel?
• Which symptoms should I anticipate in accordance with the nerves implicated?
• Do I need medication or surgery?
• What will happen during surgery?

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(8)Conclusion

Eagle syndrome is a rare but treatable illness that can result in ongoing pain in the throat, neck, face, or ears, which frequently manifests following a tonsillectomy or other head and neck operations. The pain arises when a long styloid process or calcified stylohyoid ligament compresses surrounding nerves or blood vessels. The underlying cause can be identified through careful diagnosis via imaging and ENT assessment, even if the symptoms can be annoying and resemble those of other disorders.

The good news is that most patients experience noticeable relief with the appropriate therapy. Mild symptoms may be managed with medication, but the underlying anatomical issue can be fixed with a styloidectomy. For an assessment and treatment plan, see an ENT expert if you have persistent pain after tonsil surgery or if your symptoms resemble Eagle syndrome. Early diagnosis and the correct treatment plan can help you get back to a regular, pain-free life.

A message from the Prabha ENT Clinic

Even a small number of additional centimeters of hard tissue in Eagle syndrome can result in pain that causes you to be cautious about moving your head or making facial expressions. The positive thing is that you don’t have to make living with Eagle syndrome symptoms your new normal. Eagle syndrome is curable. Your healthcare professional can tell you if you need medicine or surgery.

If any patient has any ENT -Ear nose throat problems and requires any , consultation ,online consultation ,or surgery in clinic of  ENT specialist Doctor Dr Sagar Rajkuwar ,he may TAKE APPOINTMENT BY CLICKING ON THE LINK GIVEN BELOW-

www.entspecialistinnashik.com 

Clinic address of ENT SPECIALIST doctor Dr Sagar Rajkuwar-

Prabha ENT clinic, plot no 345,Saigram colony, opposite Indoline furniture Ambad link road ,Ambad ,1 km from Pathardi phata Nashik ,422010 ,Maharashtra, India-Dr Sagar Rajkuwar (MS-ENT), Cell no- 7387590194   ,  9892596635

DISCLAIMER-Some patients go to net and directly take treatment from there which can lead to catastrophic consequences-Then- Many people ask then why to read all this text -the reason is that it helps you to understand the pathology better ,you can cooperate with treatment better ,your treating physician is already busy with his patients and he does not have sufficient time to explain you all the things right from ABCD ,so it is always better to have some knowledge of the disease /disorder you are suffering from.

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