Peculiarities of the investigation, clinics and treatment of stylohyoid syndrome and glossopharyngeal neuropathy

Albinas Gervickas, Ričardas Kubilius

Department of Maxillofacial Surgery, Kaunas University of Medicine Hospital, Lithuania

Key words: stylohyoid syndrome, glossopharyngeal neuropathy, investigation, clinics, treatment.

Summary. The aim of the study was to investigate the causes and the clinics of stylohyoid syndrome and its tendency to convert into glossopharyngeal nerve neuropathy; to investigate clinical peculiarities of glossopharyngeal neuropathy; to estimate differential diagnosis criteria for the glossopharyngeal neuropathy and stylohyoid syndrome; as well as to propose optimal treatment of the neuropathy.

Material and methods. Sixty-five patients with stylohyoid syndrome and 53 patients with glossopharyngeal neuropathy have been treated on. The diagnosis was estimated according to the data of clinical and X-ray investigation. For the localization of affected zone we performed modified facial straight plain radiograms of the patients in open bite position, facial oblique contact radiograms, orthopantomograms and cervical spondylograms.

Results. The majority of the patients were females; they comprised 61.5% of patients with stylohyoid syndrome and 56.6% of glossopharyngeal neuropathy sufferers. Older persons had neuropathy, younger – stylohyoid syndrome. The mean age of neuropathy patients was 63.8 years, and of stylohyoid syndrome – 57.1 years. Seven years and longer duration of disease was observed in 73.3% of glossopharyngeal neuropathy patients, while duration of 7 and more years was observed in only 3.1% of stylohyoid syndrome patients. The mean duration of glossopharyngeal neuropathy was 10.9 years, and of stylohyoid syndrome – 2.6 years. The analysis of etiological factors showed they are the same for both diseases.

Conclusions. The core of the glossopharyngeal neuropathy pathogenesis is destruction at the glossopharyngeal nerve or at the perivascular plexus of carotid artery, because of elongation or dislocation of styloid processus in case of neck osteochondrosis and compression by ossified styloid ligament. In case of stylohyoid syndrome, inflammatory processes occur at the above-mentioned nervous elements.

Correspondence to R. Kubilius, Department of Maxillofacial Surgery, Kaunas University of Medicine Hospital, Eivenių 2, 50010 Kaunas, Lithuania. E-mail: r.kubilius@kmu.lt

Received 23 February 2004, accepted 17 June 2004