Eagle syndrome surgical treatment with piezosurgery.
BACKGROUND
Eagle syndrome (ES) is an uncommon complication of styloid process elongation with stylohyoideal complex symptomatic calcification. It is an uncommon condition (4% of the population) that is symptomatic in only 4% of the cases. Eagle syndrome is usually an acquired condition that can be related to tonsillectomy or to a neck trauma. A type of ES is the styloid-carotid syndrome, a consequence of the irritation of pericarotid sympathetic fibers and compression on the carotid artery. Clinical manifestations are found most frequently after head turning and neck compression. Although conservative treatment (analgesics, anticonvulsants, antidepressants, local infiltration with steroids, or anesthetic agents) have been used, surgical treatment is often the only effective treatment in symptomatic cases.


METHODS
We present the case of a 55-year-old patient, successfully treated under endotracheal anesthesia. The cranial portion of the calcified styloid process was shortened through an external approach, using a piezoelectric cutting device (Piezosurgery Medical II; Mectron Medical Technology, Carasco, Italy) with MT1-10 insert, pump level 4, vibration level 7.


RESULTS
No major postoperative complications such as nerve damage, hematoma, or wound dehiscence occurred. After 6 months, the patient was completely recovered. Two years after the surgery, the patient did not refer any symptoms related to ES.


CONCLUSIONS
The transcervical surgical approach in patients with ES seems to be safe and effective, despite the remarkable risk for transient marginal mandibular nerve palsy. This risk can be decreased by the use of the piezoelectric device for its distinctive characteristics--such as precision, selective cut action, and bloodless cut.
From the *Dentistry and Maxillofacial Surgery Section, University of Verona, Verona, Italy; †Department of Dentistry and Maxillo-Facial Surgery, University of Modena, Modena, Italy; ‡University of Paris, Paris, France; and §Stomatology and Oral Surgery, Department of Health Sciences, University of Eastern Piedmont "A. Avogadro," Novara, Italy.
Dario
D
Bertossi
Massimo
M
Albanese
Luigi
L
Chiarini
Claudia
C
Corega
Carmen
C
Mortellaro
Pierfrancesco
P
Nocini
D000368:Aged; D000770:Anesthesia, Endotracheal; D002114:Calcinosis / Q000175:diagnosis / Q000601:surgery; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000175:diagnosis / Q000601:surgery*; D059745:Piezosurgery; D011183:Postoperative Complications / Q000601:surgery; D011862:Radiography, Panoramic; D013701:Temporal Bone / Q000002:abnormalities* / Q000601:surgery; D014057:Tomography, X-Ray Computed