BACKGROUND: Eagle's syndrome is a condition caused by an elongated styloid process and is characterized by various symptoms such as cervicofacial pain, foreign body sensation, headache, odynophagia, and otalgia. However, the occurrence of a unilateral peripheral facial palsy as a symptom of Eagle's syndrome has been described only rarely. METHODS: We report the case of a 60-year-old male patient who presented with a sudden and unprovoked onset of retroauricular pain on the left side, accompanied by peripheral left facial palsy. Imaging revealed an extensively elongated styloid process on the left side. Based on the clinical and radiological findings, a spontaneous fracture of the styloid process with subsequent inflammatory reaction compromising the nearby facial nerve was suspected. Surgical resection of the elongated styloid process was performed. RESULTS: Three months after surgery, the peripheral left facial palsy, which had shown no preoperative improvement for many weeks, had improved from House-Brackmann grade IV° to II°. No other symptoms were present postoperatively. CONCLUSIONS: We present a rare case of Eagle's syndrome complicated by unilateral peripheral facial palsy that improved following surgical resection of the elongated styloid process.
Holtmann et al. (Mon,) studied this question.