茎突舌骨综合征23例诊治分析

Diagnosis and treatment of 23 cases with stylohyoid syndrome

目的:探讨茎突舌骨综合征的诊断和治疗特点。方法:对经手术治疗的23例茎突舌骨综合征的临床资料进行回顾性研究,探讨其临床症状、年龄、性别、茎突长度、临床检查等在该病中的特点,比较口咽径路和颈外径路手术治疗的价值。结果:(1)口咽部疼痛和异物感是该病的主要症状,占83%(19/23),其次为头痛、舌痛和耳部不适,占43%(10/23)。(2)女性发病多于男性。50～59岁和30～39岁为好发年龄,分别占43%(10/23)和30%(7/23)。(3)切除之茎突中91%(21/23)长度大于3cm,9%(2/23)的茎突短于3cm,但形态异常。(4)57%(13/23)的过长茎突可从口咽部触及。(5)通过颈外径路手术治疗能够安全、彻底地切除各种类型的病变茎突。结论:茎突舌骨综合征是头颈部疼痛的原因之一,完整的病史、仔细的茎突触诊以及影像学检查有助于该病的诊断。经颈外径路行茎突截除术是治疗该病的有效方法。

PURPOSE:To assess the diagnosis and treatment of stylohyoid syndrome. METHODS: The clinical data of 23 patients with stylohyoid syndrome were analyzed retrospectively,the symptoms,age,gender,length of styloid process,and clinical signs were investigated in their relationship to the disease onset , the value of styloidectomy via transoral and extraoral approach was compared. RESULTS: (1) Pain and foreign body sensation in oropharyngeal area accounted for 83%(19/23) of the symptoms ,followed by 43%(10/23) of headache,tongueache and periauricular discomfort. (2) Females were more often affected than males. The age peak was 50s and 30s ,accounting for 43%(10/23) and 30%(7/23) respectively. (3) 91%(21/23) of the excised styloid processes were longer than 3cm in length, 9%(2/23)of them shorter than 3cm but with abnormality in shape. (4) 57%(13/23)of the elongated styloid processes could be palpated transorally. (5) Through extraoral approach, all kinds of diseased styloid processes could be excised thoroughly and safely. CONCLUSIONS: Stylohyoid syndrome is one of the causes of head and neck pain. A complete medical history , careful palpation of the oral pharyngeal area, and radiographic examination are essential for the diagnosis.Styloidectomy by extraoral approach is effective for curing of the disease.