Eagle’s syndrome can cause the following symptoms: throat pain, a lump or stuck feeling in the throat, pain when swallowing, neck pain and ear pain.
Eagle’s syndrome happens when a small bony projection at the base of the skull, called the styloid process, is longer than normal, or, when the ligament attached to it becomes calcified or hardens.
This extra bone or stiffness can press on nearby nerves or blood vessels in the neck and throat.
The condition was first described by Watt W. Eagle in Archives of Otolaryngology in 1937, and the basic explanation still applies today.
How common is Eagle’s syndrome?
An elongated styloid process itself is not rare. Imaging studies reviewed by Piagkou et al. in Clinical Anatomy (2009) show that about 4 to 7 percent of adults have this anatomical variation.
However, only a very small percentage of those people actually develop symptoms.
Eagle originally estimated symptomatic cases at around 0.16 percent of the population, which later reviews have supported.
Main Causes and Risk Factors
There is no single cause of Eagle’s syndrome.
Research suggests it may be congenital in some people, while in others it develops over time due to aging, ligament calcification, prior throat surgery such as tonsillectomy, or neck trauma.
This multifactorial explanation is outlined by Ghosh et al. in Journal of Craniofacial Surgery (2014).
When symptoms arise, the patient is often in their 30s to 50s.
Common Symptoms
Symptoms are often vague and can mimic other head and neck conditions.
In fact, this conditions is sometimes misdiagnosed as TMJ disorder or migraine disorder, since it can also cause headache.
Many people report throat or neck pain that worsens when swallowing, chewing, yawnin, or turning the head.
You can see how a doctor might immediately think of temporal mandibular joint disorder.
Ear pain, headaches, facial pain and a persistent feeling of something stuck in the throat are common complaints.
Vascular and Atypical Symptoms
In a less common form, the elongated styloid process can irritate the carotid artery.
This may cause pain along the side of the neck or head and sometimes dizziness or neurologic-type symptoms.
This vascular presentation is described by Badhey et al. in The American Journal of Otolaryngology (2017).
Diagnosis and Evaluation
Diagnosis usually involves a combination of physical exam, symptom history and imaging such as CT scans.
Imaging helps confirm styloid length and its relationship to nearby structures.
Treatment Options
Treatment often starts conservatively with pain relievers, anti-inflammatory medications or steroid injections.
For people with persistent or severe symptoms, surgical shortening of the styloid process can be effective.
In rare cases, Eagle’s syndrome can compress a carotid artery, potentially causing stroke or serious vascular complications.
The treating physician would be an ear, nose and throat specialist (otolaryngologist).
