Bilateral eagle syndrome: A rare entity

Abstract

Elongated styloid process or Eagle syndrome is a rare condition presenting with a wide range of symptoms including throat pain, foreign body sensation, neck pain, and ear pain. Establishing a diagnosis requires a high index of suspicion and understanding of this entity by the physician. Computed tomography (CT) is the gold standard to diagnose Eagle syndrome. Conservative medical treatment with analgesics, oral steroids, and anticonvulsants are offered in patients who refused surgery. The mainstay of treatment is surgical resection through transoral or transcervical approaches. We describe a rare case of bilateral Eagle syndrome which presented with chronic foreign body sensation in the throat but aggravated by fish bone ingestion. Flexible nasopharyngolaryngoscopy (FNPLS) and cervical x-ray did not reveal any foreign body but showed an incidental finding of elongated styloid process bilaterally. Contrast-enhanced CT scan of the neck confirmed the finding of the elongated styloid process bilaterally. The patient underwent transoral endoscopic assisted bilateral styloidectomy following tonsillectomy. There was complete resolution of the symptoms during postoperative follow-up. This approach is recommended to avoid external scarring, minimize postoperative pain, and shorter hospital stay.