Eagle syndrome is rare and often misdiagnosed, but it has a very distinctive type of pain and a good surgical solution. In this video, ENT surgeon Dr John Charles Hodge explains what causes it, how it is diagnosed, and the two ways he treats it.
What is Eagle syndrome?
Eagle syndrome occurs when the styloid process, a small bone at the base of the skull, or the ligament connecting it to the hyoid bone in the neck, becomes elongated or calcified. The glossopharyngeal nerve wraps around it and can be irritated when the head turns.
Key points from the video
- A rare, often misdiagnosed condition. Eagle syndrome is uncommon, and its pain is easily confused with jaw (TMJ), neck or muscular problems.
- A distinctive twanging pain. When the head turns, the nerve twangs over the elongated bone, causing a sharp pain a bit like hitting your funny bone.
- The treatment is surgical. Removing the elongated bone fixes the Eagle syndrome pain, although it won’t fix any separate muscular or joint issues.
- Two surgical approaches. Dr Hodge offers both robotic surgery through the mouth and the traditional approach through the neck.
- Robotic surgery is scarless. The robotic approach leaves no neck scar, which offers privacy as well as a cosmetic benefit, but recovery can be harder and it isn’t suitable for everyone, such as people with diabetes or on steroids.
Video transcript
Hi, my name is John Charles. I’m an ear, nose and throat doctor, and I’m going to talk to you today about Eagle syndrome.
This is a really quite rare condition, but I do see it from time to time, and it’s frequently misdiagnosed. Essentially, you’ve got a little bit of bone that comes out of the bottom of your skull base, which is connected by a tendon to the hyoid bone, which is down here at the top of your larynx. Occasionally that tendon can calcify.
Wrapping around that tendon is a nerve called the glossopharyngeal nerve, which supplies the back of the tongue. When the styloid process elongates, or the tendon becomes calcified, you’ve got a long, spiky bone, and when you turn your head in a certain position, the glossopharyngeal nerve twangs over it. So it’s a bit like hitting your funny bone, and it’s a very distinctive sort of pain.
In fact, it’s a self-defence move in jiu-jitsu that I used to teach. If someone’s holding you around the waist and you want them to let go, you put pressure underneath the jaw here and press towards the centre of the skull base, and you’re pressing on that nerve. The pain is exquisite.
Now, the problem is that people do genuinely have this, but a lot of other things cause pain in this area. Many people get TMJ or jaw issues, cervical spine issues and musculoskeletal issues. So you’ve got to differentiate those from Eagle syndrome, because the treatment for Eagle syndrome is to remove that spiky bone.
There are two ways of doing this, and I offer both. One is through the mouth, robotically, and one is through the neck, which is the traditional approach. There are pros and cons to both. Doing it robotically is scarless, but it’s probably a harder recovery because you do have an incision in the mouth, and I normally wouldn’t do this in people I’m worried about healing, like diabetics or people on steroids.
But there’s a big advantage. There’s the cosmetic advantage of not having a cut on the neck, but it also gives you privacy. If you’ve got a cut on the neck, everyone’s going to ask you what you had done, and it’s quite powerful to not have that reminder for other people, because it’s really none of their business unless you want to tell them.
So it’s about patient selection. You’ve got to have that twanging pain, like a funny bone pain, and then surgery to remove that spiky bone basically fixes you. It’ll still leave any other musculoskeletal issues, but it’s a very good fix.
So it’s a rare condition, and most people don’t really understand it, but it does have a good surgical solution. Hopefully you found that helpful.
Talk to Dr Hodge about Eagle syndrome
If you have pain that sounds like Eagle syndrome and would like it assessed, book an appointment or get in touch with the rooms.
This information is general in nature and is not a substitute for personalised medical advice. Please speak with your GP or specialist about your individual situation.