Uncovering a rare discovery: a singular account of osteoma in the stylohyoid chain

Abstract

Clinical Presentation

A 54-year-old male patient presented to the clinic for a periodic check-up. A panoramic radiograph taken in 2022 showed ossification of the stylohyoid ligament on both sides with an oval radiopacity on the right side. Recent cone beam computed tomography revealed a well-defined, homogenous, and hyperdense entity, arising from the lower third of the ossified stylohyoid ligament on the right side, close to the hyoid bone.

Differential Diagnosis

Osteoma of the stylohyoid chain shares similar morphologic features to Eagle's syndrome and stylohyoid syndrome, demonstrating calcification or ossification of the stylohyoid ligament. Other conditions include epidermal inclusion cyst of the styloid process, osteochondroma of the styloid process, and benign tumors of the hyoid bone, parapharyngeal space, and salivary gland. Osteoma itself is further classified as compact (ivory), spongy (trabecular), or combined, depending on the proliferation of compact or trabecular bone. It can also have three subtypes based on the location: central, peripheral, and extraskeletal.

Diagnosis and Management

Due to the asymptomatic status of this case, the case is being monitored and no surgical intervention is advised at present. General microscopic features of osteoma include mixture of mature, dense lamellar and woven bone patterns. If the osteoma becomes symptomatic, it can be removed by either minimally invasive endoscopy or open surgery. Occasionally, partial resection of the ossified stylohyoid ligament is performed.

Conclusion

Osteoma, a benign tumor commonly found in the long bones of the body, rarely manifests within the neck region. Even more infrequent are tumors originating from the stylohyoid chain, with only a single documented case of osteoma reported in the medical literature back in 1993. This unique case delves into the details of an osteoma that emerged from the stylohyoid chain, marking it as the second recorded occurrence of this peculiar condition.