A 35-year-old woman presented in the accident and emergency department with a 2-day history of right-sided Horner’s syndrome. She had been seeing her GP over the last few months with right-sided neck pain, often brought on by chewing, and occasional tinnitus and dizziness, for which no cause had been found. Physical examination, other than right-sided Horner’s syndrome, and chest imaging and head computed tomography (CT) were unremarkable. A 3D CT scan of the cervical region demonstrated elongation of the right styloid process, and bilateral ossification of the stylohyoid ligaments, more marked on the right, postulated to be impinging the sympathetic chain on the right causing ipsilateral Horner’s syndrome. She was referred to an ear, nose, and throat (ENT) specialist for further management of suspected Eagle syndrome.
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