We experienced a case of an elongated styloid process that was 8 cm in length. The patient was a 68-year-old Japanese man with frequent episodes of left-sided throat pain for 10 years. The elongated styloid process could be diagnosed by 3D-computed tomography (left and right length: 7.8 cm and 8.0 cm, respectively) and successfully treated with surgery, since the anatomic relationships could be fully visualized. Surgical methods for shortening an elongated styloid process involve an intraoral or external approach. The external approach to the styloid process involves a trans-cervical approach to the parapharyngeal space, which enables wider visualization in the operative field than an intraoral approach. In the present case, the styloid process reached the parapharyngal space. Therefore, we selected the external approach and shortened only the left-sided styloid process (the same side as the throat pain). The chief complaint disappeared immediately after the operation.
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