Styloid syndrome with abnormal styloid process causing earache:a report of 38 cases

Wang Yongfu; Yu Yaping; Yu Wei; Chen Xiaohua; Dong Qianqian; Pang Qiran; Song Qing; Xu Yongxiang; Yu Jun; Jiang Shaohong; Zhang Qingqua

doi:10.19617/j.issn1001-1307.2024.04.57

Abstract：Objective To investigate the diagnosis,treatment and therapeutic effect of styloid syndrome caused by abnormal styloid process.Methods 38 cases of styloid syndrome caused by abnormal styloid process were diagnosed by pharyngeal palpation and imaging examination.According to the symptoms and wishes of the patients,styloid process truncation or hyphoglosopharyngeal nerve termination amputation or blocking treatment and drug treatment were performed,and the treatment methods were analyzed.Results After 6 months to 3 years and 3 months of follow-up,the ear pain caused by abnormal stimulation of the surrounding tissue of the styloid process was cured in 16/21 of the 26 patients,accounting for 76.19%.Obvious effect was found in 3/21 cases,accounting for 14.28%;Invalid cases were 2/21,accounting for 9.52%;5.The pain was obviously improved by pharyngeal block treatment and drug treatment,and could be tolerated.Pharyngeal block therapy and drug therapy were still effective in 2 patients who failed to receive surgical treatment.Ear pain caused by abnormal stimulation of glossopharyngeal nerve caused by styloid process disappeared after operation in 9 of 12 patients.The 7 patients did not have pain attack,among which 2 patients did not find the glossopharyngeal nerve terminal branch,and 1 case had severe pain more than 1 year after surgery,and was cured by retrosinusoid approach glossopharyngeal nerve amputomy.1 case had pain 7 months later,but it was significantly reduced,and local blocking treatment and drug treatment improved.The 3 cases with effective pharyngeal closure were continued to be observed and treated because the pain was tolerable.No complications occurred in all patients.Conclusion Although the styloid syndrome caused by abnormal styloid process is relatively rare in clinic,missed diagnosis should be avoided.After the diagnosis is confirmed by pharyngeal palpation and imaging examination,styloid process truncation or glossopharyngeal nerve termination amputation is accurate.