{"title":"A case of cerebral infarction in which a carotid artery stent was fractured by an elongated styloid process(eagle syndrome)","authors":"Nobuhiro Yoshimi , Hiromitsu Hatakeyama , Kazuo Matsui , Noriyuki Katsumata , Satoshi Yamada , Kiyoshi Misawa","doi":"10.1016/j.ajoms.2025.04.012","DOIUrl":null,"url":null,"abstract":"<div><div>Eagle’s syndrome is characterized by laryngopharyngeal hypersensitivity, such as sore throat and dysphagia in otorhinolaryngology. It is caused by mechanical pressure from the styloid process that extends to ≥ 25 mm. In most cases, the symptoms appear unilaterally. There are two primary symptoms as follows: (i) classic stylohyoid syndrome, which occurs after tonsillectomy; (ii) stylo-carotid artery syndrome, which involves compression of the carotid artery or sympathetic nerve. We experienced a case of repeated cerebral infarctions due to stylo-carotid artery syndrome. Details of the case are shown below. An elongated styloid process caused three times cerebral infarctions due to internal carotid artery dissection. Internal carotid artery dissection treated with carotid artery stent. But after that, the carotid artery stent was fractured by the styloid process compression. As a result, he suffered a fourth cerebral infarction due to embolization caused by the stent fragments. Using CT angiography and angiography, we diagnosed carotid artery dissection and carotid stent fracture due to an elongated styloid process. In addition to medical therapy for cerebral infarction, we surgically resected the styloid process to prevent recurrence. The scattered stent fragments in the cerebral artery were difficult to remove and were left behind. However, he has not had a recurrence two and a half years. In order to prevent repeated or iatrogenic cerebral infarction, we believe that an elongated styloid process should be resected before stent treatment.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 5","pages":"Pages 1027-1030"},"PeriodicalIF":0.4000,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2212555825000870","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Eagle’s syndrome is characterized by laryngopharyngeal hypersensitivity, such as sore throat and dysphagia in otorhinolaryngology. It is caused by mechanical pressure from the styloid process that extends to ≥ 25 mm. In most cases, the symptoms appear unilaterally. There are two primary symptoms as follows: (i) classic stylohyoid syndrome, which occurs after tonsillectomy; (ii) stylo-carotid artery syndrome, which involves compression of the carotid artery or sympathetic nerve. We experienced a case of repeated cerebral infarctions due to stylo-carotid artery syndrome. Details of the case are shown below. An elongated styloid process caused three times cerebral infarctions due to internal carotid artery dissection. Internal carotid artery dissection treated with carotid artery stent. But after that, the carotid artery stent was fractured by the styloid process compression. As a result, he suffered a fourth cerebral infarction due to embolization caused by the stent fragments. Using CT angiography and angiography, we diagnosed carotid artery dissection and carotid stent fracture due to an elongated styloid process. In addition to medical therapy for cerebral infarction, we surgically resected the styloid process to prevent recurrence. The scattered stent fragments in the cerebral artery were difficult to remove and were left behind. However, he has not had a recurrence two and a half years. In order to prevent repeated or iatrogenic cerebral infarction, we believe that an elongated styloid process should be resected before stent treatment.