Headache / Migraine Neurology / Neuroscience

What is Eagle syndrome?

Eagle syndrome is a condition that causes pain in the throat and face. It is typically caused by an unusually long styloid process bone, which is a pointy bone just beneath the ear.

The pain caused by Eagle syndrome is a type of nerve pain, which means it is caused by unusual nerve signals, not damage to the painful area.

The pain is typically a dull and throbbing ache that may include a feeling that something is stuck in the throat. Some people also experience tinnitus and neck pain.

According to the Genetic and Rare Diseases Information Center (GARD), about 4 percent of the population has an unusually long styloid process. However, only between 4 and 10 percent of these people — around 1 in 62,000 people — have any symptoms. GARD also note that Eagle syndrome is more common in women than in men, with about three times as many women as men having symptoms.

In this article, we examine the symptoms of Eagle syndrome along with the possible causes. We also look at how the condition can be treated with surgery and managed without it.

Symptoms of Eagle syndrome

Woman holding side of jaw and face because of eagle syndrome pain, while sitting in bed.
Eagle syndrome may cause pain around the jaw, throat, and ear.

Many people have an unusually-shaped styloid process but no symptoms. When symptoms do appear, they often include:

  • swallowing difficulties
  • a feeling that there is something stuck in the throat
  • shooting pains from the throat to the ear or jaw
  • pain at the base of the tongue
  • pain when swallowing or turning the head to one side
  • a persisting ringing or buzzing in the ears
  • a headache
  • throbbing in the jaw

Some people experience other symptoms, such as unusual sensations in the head or the neck.


Causes

In most people, an elongated styloid process bone is the culprit in Eagle syndrome. Some people develop a long styloid process after a throat injury or surgery. In others, this is merely an anatomical difference or a change related to age. An elongated styloid process may put pressure on the throat and compress nearby nerves or blood vessels, causing pain.

Other causes of Eagle syndrome include:

  • Tonsillectomy: Sometimes, after having their tonsils out, people develop scar tissue in and around the throat. This can put pressure on surrounding nerves, causing pain and ringing in the ears.
  • Calcification of the stylohyoid ligament: Some people develop calcium deposits on the stylohyoid ligament, which attaches to the styloid process. Most people do not develop symptoms, but some may experience pain and other unusual sensations.

Treatment

Man wearing surgeons scrubs and mask in operating theatre.
Surgery is a common and effective treatment for Eagle syndrome.

Surgery to shorten the styloid process is the primary treatment for Eagle syndrome. This procedure, called a styloidectomy, can be done through the mouth or neck.

Surgery through the mouth requires removal of the tonsils , and it can be more difficult for the surgeon to access the styloid process. There is also a slightly increased risk of damage to surrounding blood vessels.

Surgery through the neck offers better access to the styloid process but will produce a scar. It can also damage surrounding parts of the body and nerves of the face.

Some doctors now offer endoscopic surgery, which uses a tube with a camera attached to access the styloid process.

A 2017 study that examined this process found that 107 of 133 people who had the surgery experienced complete relief of symptoms, with an additional 20 getting partial relief. A total of 122 were satisfied with the appearance of the small cut afterward. These findings suggest that this surgery may be a good option for reducing symptoms.

Management of Eagle syndrome

No surgery is risk-free, and not all styloidectomies work. Some people may choose to find other strategies to manage their symptoms or do not get relief from surgery.

Some strategies that may help with pain management include:

  • pain medication, such as nonsteroidal anti-inflammatory drugs (NSAIDs)
  • steroid injections
  • alternative and complementary medicine

Eagle syndrome is a type of nerve pain, meaning that there is not an injury to the painful area. As a result, massage, exercise, and other strategies that target the painful area are unlikely to help.


Diagnosis

A doctor may suspect Eagle syndrome based on the symptoms that a person presents. However, it is essential that doctors rule out other possible causes of pain in this area of the body, such as:

  • tooth pain radiating to the neck
  • problems with nearby blood vessels
  • ear infections
  • physical injuries to the jaw
  • herniated discs

A doctor may ask about symptoms, take a complete medical history, and perform a physical examination. Imaging studies, such as X-rays, can help a doctor view the styloid process and surrounding structures.

In some cases, a doctor may be able to feel an unusually long styloid process pushing into the throat.

Outlook

Doctor at des in office talking to patient.
If untreated, Eagle syndrome may cause emotional distress.

About 80 percent of people who seek treatment for Eagle syndrome get relief, regardless of the treatment they receive.

For people who undergo surgery, the outlook may be even better. According to one study, around 95 percent of people receiving endoscopic surgery for Eagle syndrome said that their symptoms were either wholly or partially relieved.

For people who choose not to undergo surgery or for whom surgery does not work, Eagle syndrome may be a chronic condition. With medical management, symptoms can improve but are unlikely to disappear completely.

Eagle syndrome is not a progressive illness and will not cause other medical conditions. However, some people find that the pain gets worse with time, or that it spreads to other areas of the body.

Living with chronic pain can also cause depression, anxiety, and relationship problems. People who do not get full pain relief may benefit from support groups, therapy, and other forms of psychological support.


Conclusion

Eagle syndrome can be frustrating, making it painful to talk, eat, or even turn the head.

A person with this condition may worry that something is seriously wrong and delay medical treatment out of fear. However, Eagle syndrome is highly treatable, with excellent outcomes for most people who seek treatment.

Anyone who experiences symptoms associated with Eagle syndrome should see a doctor who specializes in pain conditions, or ask a dentist or primary care physician for a referral.

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