Elongated Styloid Process: A Rare Presentation As A Tonsillar Mass

摘要

Elongated styloid process causing Eagle's Syndrome is a rare clinical entity. The diagnosis is often difficult because of its vague symptomatology. Palpation of tonsillar fossa with radiological demonstration of the elongated styloid process confirms the diagnosis. We report a rare case of elongated styloid process presenting as tonsillar mass Introduction Elongated styloid process is a rare clinical condition, which often presents with vague cervicofacial pain, foreign body sensation in the throat, dysphagia, facial pain and referred otalgia. The patient presents to the dentist or otolaryngologist with these symptoms. Diagnosis is usually done by palpating the tonsillar fossa for an unusually elongated styloid process. The diagnosis is confirmed by soft tissue lateral radiograph of neck, orthopantomogram or a computed tomography scan (CT scan.) This paper reports an unusual presentation of an elongated styloid process presenting as a mass in the tonsillar fossa. Case Report A forty one year old man presented to the ENT clinic with history of foreign body sensation in the throat and vague pain in the right tonsillar fossa for more than six months duration. He was a chronic smoker. Examination of oropharynx revealed a smooth mass arising in the right tonsillar fossa measuring about 4 x 4 centimetres. On palpation the mass was firm in consistency with lobulations. The opposite tonsil was normal in size and appearance. Fibreoptic flexible endoscopic examination of the postnasal space and rest of pharyngo-larynx was normal. There was no lymph gland enlargement in the neck or else where in the body. There was no hepato-splenomegaly. Tonsillectomy was considered to diagnose lymphoma or malignancy.The patient underwent right tonsillectomy under general anaesthesia. After removal of the tonsil, a sharp elongated styloid process measuring about two cm in length was pointing into the tonsillar fossa .The pericapsular tissue showed exuberant red granulation tissue. The elongated styloid process was amputated and smoothened .The tonsil was sent for histopathology, which revealed non-specific granulation tissue. On six months follow up patient was symptom free.