To describe the role of active surgical management in cases of pharyngodynia attributable to styloid enlargement. The purpose of this study is to assess the postoperative recovery time and improvement in pain score.
Study design: Retrospective-Prospective analysis of a case series. Methods: Twenty seven patients of chronic Pharyngodynia with no other discernible cause except a possible association with styloid process directly or indirectly were analysed. Nineteen patients were operated using established technique of Tonsilostyloidectomy, with slight modifications. A minimum follow-up of 12 weeks was considered. Main outcome measures were the postoperative pain score and time taken to wean off drugs.
Results: The incidence of stylgia, classical Eagles syndrome, was found to be 0.44 per 1000 ENT OPD visiting people at MMABM Hospital. The mean age at presentation was found to be 40.70 years. The Females cases were more than twice as common as males. The average duration of symptoms was 22 months at presentation, and bilateral symptoms were found in 9 out of 10 patients, with left and right predominant in 5 cases each. The patients had varied symptomatology with oropharyngeal pain as most common. The average styloid process size was found to be 3.99 cm on right and 4.29 cm on left. All patients were operated by intraoral tonsilostyloidectomy method, and 0.8 to 2.5 cm bone size removed. Three of the patients were off all drugs within 3 week time, while 9 more patients were weaned off in 6 week time and 5 more in two months. The ratings on visual analogue scale for pain changed from 7.36 +/- 1.02 to 3 +/- 1.75. Complete resolution was achieved in 17/19 patients, (89.4%).
Conclusion: A high index of suspicion and an active look out for enlarged styloid processes in cases of chronic pharyngeal pain is highly recommended. Patients diagnosed with stylgia should be actively counselled for surgical intervention. The surgical approach, i.e. intraoral tonsilostyloidectomy, is a safe and highly effective procedure.