Question
"Hello and first thank you for answering my question.
Years ago I was diagnosed with elongated styloid process on a cat scan. This said it could cause upper phalangeal discomfort.
Back to the present day, I've been having dizziness and balance problems for around 9 weeks. Friends suggested this could be Eagles Syndrome, so I had a cat scan results:
History: Dizziness and ear pain
Technique: Non-contrast scans
Findings: The ventricles and extra-parenchymal fluid spaces appear normal. There is no midline shift. There are no areas of abnormal parenchymal attenuation or swelling. There is no mass lesion, haemorrhage or surface fluid collection.

No petrous temporal abnormality seen on either side, with normal pneumatisations of the middle ear cavities and mastoid air cells. Internal auditory canals and remaining inner ear structures appear normal. No petrous temporal soft tissue mass or bony destruction.

Mind - moderate polypoid inflammatory mucosal thickenings in both maxillary sinuses, significantly worse on the left. Minor mucosal thickening in the left spenoid sinus. Remaining paranasal sinuses are clear.

Comment: No intracranial or petrous temporal abnormality demonstrated.

Does this mean that my elongated styloid process has been picked up or not been shown ? If it has been shown does that mean it's doing no damage. I have tight muscles in my neck and scared that it might be affecting my carotid artery. Would the styloid bone be picked up at all and mentioned if this was a problem.

Kind Regards

Karen

Answer
Hi Karen,

I cannot imagine that CT would not have picked up findings of an elongated styloid process. Usually, the prescribing doctor would note any previous findings in order to rule this out as a possibility. There are many additional symptoms with Eagle's syndrome; one of the main ones is dysphagia of pain on swallowing, along with pain along the glossopharyngeal nerve. There can be neck pain and side of head pain as well.

What is suggested is sinus problems, however, an otolaryngologist would evaluate this. It is also possible you could be evaluated for canalith repositioning for possible benign paroxysmal positional vertigo. This is often done by a therapist and is usually an Epley's maneuver or variations thereof.

So, it is difficult to imagine Eagle's syndrome as a primary diagnosis, given your concern and previous history of CT confirmed elongated styloid process. So, this concern should be noted to the prescribing physician and/or radiologist.

In any event, your concerns are always valid and I would talk to your doctor. I hope it is just an infection that can be remedied with proper medication and you will be feeling better soon. I wish I could better arrest your concerns, however; my initial impressions, given your complaints and CT results, would be negative for Eagle's syndrome.

Kind regards,

Dr. Steve
www.necksolutions.com