Eagle Syndrome causes sudden nerve pain in neck and face
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Ask the Doctors
by Eve Glazier, M.D.
& Elizabeth Ko, M.D.
Dear Doctors: My wife has been diagnosed with something called Eagle syndrome. Not a lot of medical providers in our area treat this type of illness. Any information you can give about it, including what treatments are available and which specialists we should see, would be helpful.
Dear Reader: Eagle syndrome is somewhat rare, so it’s not surprising that finding information, treatment and support have been a challenge. The condition occurs in about 1 in 62,000 people, and it is seen three times more often in women as in men.
Someone living with Eagle syndrome experiences sharp and sudden nerve pain in the neck, throat, tongue, mouth and face. Additional symptoms can include difficulty swallowing, changes to speech, headache, tinnitus, the sensation of something stuck in the throat and pain when turning the head or when chewing.
To understand Eagle syndrome, we should begin with anatomy. There’s a needlelike spur of bone in the lower part of the skull known as the styloid process. It is located near that hollow you can feel behind the earlobe, where the lower jaw abuts the throat. A ligament connects the styloid process to a small U-shaped bone in the jaw, known as the hyoid bone. Together, these three structures form a mechanism that facilitates movement of the tongue, voice box and throat, and plays an important role in swallowing and speech.
Eagle syndrome can occur when the styloid process is too long, or if the ligament connecting it to the hyoid bone becomes calcified. Hormonal changes in women, neck injury and the effects of throat surgery, such as tonsillectomy, have also been proposed as causes. Because this region of the body contains important arteries, another form of Eagle syndrome can result in the localized compression of certain blood vessels.
The primary treatment for the condition is surgery. It has been shown to have very good results. Known as a styloidectomy, or a styloid reduction, it involves reducing the size of the bone. There are several variations of this procedure, including an endoscopic procedure and one that can be done under local anesthesia. The entry point for the surgery can be through the mouth or the neck. While surgery via an incision in the neck is considered to offer the best access to the structures involved, it can leave a scar.
Before choosing surgery, some patients opt to manage the symptoms of the condition. This includes the use of pain medications, steroid injections and alternative medicines. Someone who chooses to manage the condition can work with their primary medical care provider, who can prescribe the appropriate medications, provide guidance about how to use them and monitor their efficacy and safety over time.
When surgery becomes the preferred route, it is important to find a qualified surgeon. In your case, you have indicated that this means going outside of your immediate community. Begin with an appointment with an otolaryngologist. They can confirm your wife’s diagnosis, help her explore her options and recommend a surgeon with appropriate experience.
Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.
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