title: Stylohyoid complex syndrome: a new diagnostic classification.
abstract: OBJECTIVE
  To describe stylohyoid complex syndrome (SHCS) as a new diagnostic classification of all lateral neck and/or facial pain conditions resulting from an elongated styloid process, ossified stylohyoid ligament, or elongated hyoid bone. All of these pathologic conditions result in tension and reduced distensibility of the stylohyoid complex (SHC), with resultant irritation of the surrounding cervical structures with movement of the complex.
  
  
  METHODS
  A retrospective medical chart review was performed to identify a cohort of patients who underwent surgical intervention for lateral neck and/or facial pain due to pathologic SHCS. Follow-up time of greater than 1 year is reported in 5 of 7 patients.
  
  
  METHODS
  Tertiary, academic referral center.
  
  
  METHODS
  Patients included were those given a diagnosis of SHCS who underwent surgical intervention from June 2006 through September 2009. There were 7 patients, 5 of whom were female. The age range was 38 to 53 years at time of presentation (mean age, 45.3 years). Common presenting complaints were lateral neck and oropharyngeal pain exacerbated by tongue and head movements.
  
  
  METHODS
  The pathologic areas were surgically addressed through transoral or cervical approaches.
  
  
  METHODS
  Symptoms following surgical intervention.
  
  
  RESULTS
  Seven patients (8 sides) were identified as having SHCS. Computed tomographic findings included elongated styloid processes (3 sides), ossified stylohyoid ligaments (2 sides), and elongated hyoid bones (3 sides). Computed tomographic scan, frequently with volume-rendered 3-dimensional reconstructions, identified the pathologic condition. All patients experienced clinically significant relief of presenting symptoms following surgical intervention.
  
  
  CONCLUSIONS
  Stylohyoid complex syndrome includes all lateral neck and/or facial pain conditions resulting from an elongated styloid process, ossified stylohyoid ligament, or elongated hyoid bone. Surgical intervention directed at any pathologic point to disrupt this complex relieves tension and offers patients relief of symptoms.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, 1365 Clifton Rd NE, Room A2328, Atlanta, GA 30339, USA.
authors.forename: Candice C
authors.initials: CC
authors.lastname: Colby
authors.forename: John M
authors.initials: JM
authors.lastname: Del Gaudio
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005157:Facial Pain / Q000209:etiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008022:Ligaments / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology* / Q000601:surgery; D009999:Ossification, Heterotopic / Q000145:classification / Q000175:diagnosis / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013701:Temporal Bone / Q000002:abnormalities / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome