Stylohyoid (Eagle’s) syndrome

Entrapment of nerves by the “stylohyoid complex” is an uncommon cause of neuropathic jaw & neck pain. This can be due to congenitally long styloid processes, or scarring after surgery or traumatic injury.

The stylohyoid complex connects the hyoid bone — important in swallowing & tongue movement — to the head. Made of tough cartilage & bone, the complex crosses paths with arteries & nerves in a tight space in the neck below the ear. When these arteries and nerves are entrapped, patients can experience:

  • Pain on the side of the neck
  • Pain at the angle of the jaw
  • Pain below the jaw line
  • Pain inside the throat

This can be triggered by speaking, swallowing, chewing, yawning, head turning, and other oral & neck movements.

Diagnosis

  • X-ray of the skull
  • CT with 3D reconstruction to visualize the complex
  • Physical examination by specialist
  • Diagnostic block of the glossopharyngeal nerve

Treatment

  • Surgical correction on the stylohyoid complex
  • Neuropathic pain medications
  • Viscous lidocaine for eating/speaking triggers
  • Interdisciplinary pain care

Other Conditions to Consider

Before arriving at the diagnosis of stylohyoid syndrome and proceeding with surgical correction, other more common conditions should be considered:

Neck

  • Neck arthritis involving facet joints
  • Superficial cervical plexus neuralgia
  • Neck muscle spasms
  • Esophageal diverticulum
  • Hyoid bone syndrome
  • Carotidynia

Jaw

  • TMJ dysfunction (temporomandibular joint)
  • Unerupted molar

Head

  • Migraine headache
  • Sphenopalatine neuralgia
  • Lesser occipital neuralgia

Throat

  • Chronic pharyngitis

Headache & migraines

Dr. Ming Kao View All →

Pain physician & PhD computational biologist @StanfordPain • Advanced pain interventions with CIPS & FIPP • Opinions mine & not medical advice

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