Styloid process elongation and calcification in subjects with tmd: clinical and radiographic aspects

Braz Dent J. 2012;23(4):443-50. doi: 10.1590/s0103-64402012000400023.


Knowledge of the Eagle's syndrome shows that its symptoms can be very easily confused with other types of craniomandibular disorders, especially temporomandibular disorders (TMD). The aim of this study was to find a possible correlation between the presence of TMD and elongation of the styloid process as well relate to presence of calcification of the stilohyoid chain. Fifty patients with TMD, confirmed from the RDC/TMD, were examined clinically and radiographically. Radiographic documentation consisted of digital panoramic radiograph and digital lateral cephalometric radiograph. Radiocef software (Radiomemory) was used for the analysis of radiographs by means of specific cephalometric tracing and linear measurements of the styloid process. Each radiograph was traced and measured three times with intervals of 1 month to spread the error. Statistical analysis was performed by Pearson's test (p=0.001) using Biostat 4.0 statistical software. Result showed an incidence of 76% elongation of the styloid process in the sample. There was a correlation between the bilateral measures taken in panoramic radiographs (?<0.001) and also for measures of styloid process length carried out in different panoramic radiographs and lateral cephalometric radiographs (?<0.001). It was concluded that there is prevalence of elongated styloid process in patients with TMD. However, no relationship was found between measurements on the stylohyoid chain and symptoms of headache, orofacial pain, tinnitus and vertigo.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Calcinosis / diagnosis
  • Calcinosis / diagnostic imaging
  • Cephalometry / methods
  • Diagnosis, Differential
  • Facial Pain / diagnosis
  • Female
  • Headache / diagnosis
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Male
  • Masticatory Muscles / physiopathology
  • Middle Aged
  • Ossification, Heterotopic / diagnosis*
  • Ossification, Heterotopic / diagnostic imaging
  • Pain Measurement
  • Radiography, Dental, Digital / methods
  • Radiography, Panoramic / methods
  • Range of Motion, Articular / physiology
  • Sound
  • Temporal Bone / abnormalities*
  • Temporal Bone / diagnostic imaging
  • Temporomandibular Joint Disorders / diagnosis*
  • Temporomandibular Joint Disorders / diagnostic imaging
  • Temporomandibular Joint Dysfunction Syndrome / diagnosis
  • Temporomandibular Joint Dysfunction Syndrome / diagnostic imaging
  • Tinnitus / diagnosis
  • Vertigo / diagnosis

Supplementary concepts

  • Eagle syndrome