Styloid Syndrome in Absence of an Elongated Process

Abstract

On the basis of 30 patients it is shown that it is possible to differentiate among the various forms of neck complaints a clinical entity which as a common trait exhibits marked unilateral tenderness over the tip of the greater hyoid cornu and sometimes also above the corresponding styloid process. A salient symptom is constant pain in the neck persisting for years, which radiates into the ear and is associated with a feeling of pressure in the neck, difficulty of swallowing and occasional hoarseness. Turning or inclining the head causes a typical pain. Only in four cases was it possible by palpation and X-rays to establish an elongated styloid process; in two there was calcification of the stylohyoid ligament. The etiology and pathogenesis of this disorder are discussed. From similar phenomena in other narrow bone projections of the extremities and the vertebral column the presence of insertion tendinosis is assumed. These are degenerative and inflammatory conditions in the tendon portion of muscle insertions with narrow base, directly at their anchorage to the bone. Therapy is chiefly based on heat applications, histamine iontophoresis and local infiltration of anaesthetics combined with cortisone. Injections of Impletol at the base of the tonsillar niche proved particularly effective.