Narrative review characterizes neurovascular compression phenotypes of the stylohyoid complex, highlighting dynamic anatomical interactions and a cautious surgical strategy.
Key Points
To synthesize literature on compression syndromes of the stylohyoid complex and propose a phenotype-based framework integrating neural, arterial, venous, and mixed neurovascular presentations.
Conducted a narrative, pathophysiologically organized review synthesizing landmark anatomical, clinical, and cohort studies alongside systematic reviews and meta-analyses.
Assessed diagnostic modalities including three-dimensional CT angiography/venography and catheter venography with manometry across neural, arterial, and venous presentations.
Symptomatic neurovascular compression depends more on 3D styloid process orientation, distance to the C1 transverse process, and dynamic head positioning than on styloid length alone.
Internal jugular vein narrowing occurs frequently in asymptomatic individuals, requiring clinical and hemodynamic correlation via catheter venography with manometry to establish diagnosis.
Surgical decompression demonstrates favorable outcomes in selected patients, whereas primary endovascular stenting carries a substantial complication profile in single-center observational series.