Role of Orthopantomogram as an Invaluable Diagnostic Aid for Satisfactory Evaluation of Elongated Styloid Process: A Review of Literature

Aim and objective: To scrutinize and conduct a review of the scientific literature describing the visualization of elongated styloid process (ESP) using an orthopantomogram in general population as well as in patients having oral submucous fibrosis (OSMF). Background: The styloid process, arising from the temporal bone and extending up to 25–30 mm in length, can be a cause of chronic pain and suffering. Similarly, OSMF is rapidly emerging as a widespread, debilitating collagen metabolic disorder affecting the younger population, owing to addiction to tobacco and areca nut chewing. The surgical protocol for the treatment of submucous fibrosis demands thorough postoperative physiotherapy, failure of which will lead to reoccurrence of trismus. The physiotherapeutic exercises become particularly challenging if the styloid process exhibits abnormal elongation, due to chronic inflammation and irritation. An ESP, thus, may become an impediment for patients being surgically treated for OSMF. Review results: The review was designed based on the 58 relevant articles obtained after inserting the terms “Elongated Styloid Process and Oral submucous Fibrosis” and “Elongated Styloid Process and Orthopantomogram” in the databases of PubMed and ScienceDirect, respectively during the period of September 2017 till September 2020. Conclusion: Orthopantomogram was widely used as a primary imaging investigation to evaluate the styloid process. An ESP, measuring more than 30 mm, was commonly observed in the older population and in men. The use of cone beam computed tomography and three-dimensional computed tomography was highly limited yet universally advocated in long-term studies for a more detailed scientific explanation of the occurrence and angulation of an ESP both in general population and in patients exhibiting OSMF. Clinical significance: The co-incidental finding of an ESP and OSMF must be carefully diagnosed before planning the surgical intervention in patients having submucous fibrosis. Such cases must be managed with multidisciplinary setting using single-stage procedure to maximize treatment outcome and ensure patient wellbeing.