Eagle’s Syndrome: A Case Report of a Bilateral Elongated Styloid Process

Eagle’s syndrome is symptomatic of the styloid process (SP) elongation or calcification of the stylohyoid and stylomandibular ligaments. As a result of Eagle’s various studies, 4 out of every 100 patients showed that the styloid process was long. However only 4% of these cases are symptomatic [1]. Surgical traumas such as tonsillectomy or stylomandibular chronic irritation of the ligament, proc. of styloideusosteitis, ossifying periosteitis, tendinitis or mucositis why could it be [2]. The main symptoms are facial pain, dysphagia, sore throat, earache and headache. It may be unilateral or bilateral. The styloid process can be shortened through an intraoral or external approach. The case of Eagle syndrome in a 39-year-old female patient who was diagnosed to have bilateral elongated.

The Effect of Fracture of Ulnar Styloid on Rotational Movements of the Forearm after Extraarticular Fractures of Distal Radius

Introduction: Since distal radius fractures are among the most common fractures encountered in orthopedics and one of their common complications is restriction of rotational movements of the wrist and forearm, iden-tification of factors affecting this loss of motion is of importance. This study was conducted to evaluate the relation between extraarticular distal radius fractures associated with fracture of ulnar styloid and the rota-tional movements of the wrist and forearm. Patients and methods: 47 patients with an extraarticular distal radius fracture were enrolled in a prospective case control study. The patients were visited in regular follow up intervals after treatment and at the final follow up the rotational movements of the forearm were measured. The findings were analyzed with Independent T and Chi-square tests. Findings: Ultimately 23 patients of the group 1 (intact ulnar styloid) and 24 of the group 2 (fractured ulnar styloid) completed the follow up period. At this time supination of the wrist and forearm in group 2 was significantly less than the group 1 (p< 0.001). Conclusion: It seems that the association of an extraarticular distal radius fracture with the fracture of ulnar styloid, at least in short term causes restriction of supination of the forearm, though the mechanism and clinical significance of this finding cannot be easily explained.

Incidental Finding of an Elongated Styloid Process during Tonsillectomy Procedure

Patients with recurrent throat pain, dysphagia, or facial pain symptoms might have Eagle’s syndrome due to abnormal length of the styloid process or calcification of stylohyoid ligament complex. In adults, the styloid process is approximately 2.5 cm long. The etiology of this disease is not well understood, and usually asymptomatic. In some cases, the styloid tip, which is located between the external and internal carotid arteries, compresses the perivascular sympathetic fibers, resulting in a persistent pain. The disease can be diagnosed by physical examination through digital palpation of the styloid process in the tonsillar fossa or by radiographic workup that includes anterior-posterior and lateral skull films. We report a 33-year-old woman with an incidental finding of an elongated styloid process during a routine tonsillectomy procedure.

Effectiveness of shockwave therapy for stenosing tenosynovitis of radius styloid process:a meta-analysis

Objective:To systematically evaluate the clinical efficacy of extracorporeal shock wave in the treatment of stenosing tenosynovitis of radius styloid process.Methods:All randomized controlled trials of extracorporeal shock wave in the treatment of stenotic tenosynovitis of radius styloid process were retrieved by computer.Two researchers independently screened,extracted and incorporated the literature into the literature evaluation.The quality evaluation was carried out with the bias risk assessment tool provided by Cochrane Collaboration Network,and the meta-analysis was carried out with RevMan 5.3 software.Result:According to the prescribed retrieval method,there were 8 articles and 447 subjects.The results showed that the effective rate of extracorporeal shock wave was(OR=5.37,95%CI(2.85,10.12),P<0.00001)compared with other therapies,and the difference was statistically significant.Meanwhile,there were significant differences in VAS pain score and Cooney dysfunction score.Conclusion:Extracorporeal shock wave can effectively relieve the pain symptoms of stenosing tenosynovitis of the radius styloid process,improve wrist dysfunction and improve the clinical efficiency of stenosing tenosynovitis of the radius styloid process,but a large number of high-quality studies are needed to provide more sufficient evidence.

Current situation and consideration of small splint in the treatment of distal radius fracture complicated with ulnar styloid process fracture

Objective:The incidence of distal radius fracture combined with ulnar styloid process fracture is increasing,which seriously affects the quality of life of patients.Small splint therapy of Traditional Chinese Medicine is a reliable method for the treatment of such fractures.It not only has good clinical efficacy,but also has fewer complications and high safety.However,the traditional small splint fixation does not cover the styloid process of the ulna,and the fracture of the styloid process of the ulna is closely related to the stability of the wrist joint,which has an important impact on the prognosis of the fracture.Based on this,we believe that the ulnar elongation splint can better improve the wrist function,and further prospects for related issues,in order to guide clinical practice.

Styloid Process Is the Robust Landmark for Identification of the Facial Nerve during Parotid Surgery

Objective: To identify the facial nerve trunk (FNT) very easily. quickly and accurately considering the styloid process as the robust anatomically consistent landmark during parotid surgery. Patients and Methods: This prospective study was conducted between January 2010 to December 2022 at a Tertiary care hospital. It included 130 patients: 84 (65%) males and 46 (35%) females with a mean age of 43.52 ± 15.63 years. Patients presented with pleomorphic adenoma (90), chronic sialectasis (05), parotid cyst (03), parotid sinus (01), mucoepidermoid carcinoma (28), adenoid cystic carcinoma (02) and squamous cell carcinoma (01) were subjected to superficial parotidectomy and total parotidectomy. The outcome was evaluated regarding the clinical success of facial nerve function that considered the location of the styloid process in the triangle technique for identification of the FNT during parotid surgery. Results: All 130 patients underwent superficial and total parotidectomy. The facial nerve trunk was successfully identified as the location of the styloid process in the triangle technique in all the patients with no intra-operative complications. Operative time ranged from 50 to 180 minutes with a mean time 90.70 ± 15.68 minutes. Dysfunction of the angle of the mouth due to the deficit of the marginal mandibular nerve (MMN) was noted in 5 patients (3.8%), 02 had difficulty in eye closure (1.5%). No patient reported surgical site infection, skin flap necrosis and hematoma in this series. Conclusion: Styloid process is the prominent robust landmark in the triangle technique for the identification of facial nerve trunk with relative ease, safety and accuracy in the parotid surgical procedure. This can be a very useful method to locate the FNT and minimize facial nerve injury during parotid surgery.

Isolated Dislocation of the Scaphoid with Associating Radial Styloid Fracture:A Case Report

Isolated dislocation of the carpal scaphoid is a rare injury. Such dislocation is extremely rare. In this article the authors report a twenty-eight-year-old man with isolated dislocation of the scaphoid with associating radial styloid fracture. We manage the patient with open reduction and Kirschner wire fixation. One year later there is a good functional and radiographic result.

尺骨茎突修复与否对桡骨远端骨折合并尺骨茎突骨折的疗效评价

目的评价尺骨茎突修复与否对桡骨远端骨折合并尺骨茎突骨折患者术后功能的影响。方法回顾性随访2020年10月-2021年10月入院的48例桡骨远端骨折合并尺骨茎突骨折患者,分为固定组和非固定组各24例,固定组在桡骨远端骨折固定基础上进行尺骨茎突修复手术,非固定组进行桡骨远端骨折固定。对比固定组和非固定组术后8周掌倾角、尺偏角、桡骨高度、腕关节背伸和屈曲及前臂旋转活动范围,术后12个月Gartland-Werley腕关节评估结果和愈合率。结果尺骨茎突骨折固定组和非固定组对患者腕部功能、前臂活动范围、愈合率的影响差异无统计学意义(P>0.05),但两组Gartland-Werley评分中残余畸形和客观评分项差异具有统计学意义(P<0.05),推测可能是三角纤维软骨撕裂与否对尺骨茎突骨折有影响。结论尺骨茎突骨折修复与否对桡骨远端骨折合并尺骨茎突骨折术后愈合能力不具有统计学意义,对于腕关节和前臂功能均无明显影响。

腕关节尺骨茎突旁籽骨1例

患者,女,56岁,2周前手腕部枕于头下看电视后出现左腕背、尺侧近尺骨茎突处疼痛,皮肤发红,轻微肿胀。当时考虑局部皮肤受压,自行云南白药气雾剂治疗。次日手腕部仍疼痛、皮肤发红,腕关节旋转时有弹响声,于2021年2月10日就诊于甘肃省人民医院。局部检查:左腕关节尺骨茎突部位皮肤发红、肿胀、皮温不高,无压痛及叩击痛,余无异常。左侧腕关节X线片显示(见图1):左腕关节尺骨茎突旁与三角骨间隙增图1腕关节X线片.

茎突综合征相关颈内动脉夹层致缺血性卒中1例报道

茎突过长是导致颈动脉夹层的主要解剖学异常,本文报道1例茎突过长相关颈动脉夹层导致缺血性卒中患者的诊治过程。该患者有长期的频繁低头和抬头工作史,CTA三维重建证实存在双侧茎突过长,长期机械性损伤导致左侧颈内动脉夹层,是本次缺血性卒中发生的根本原因,经左侧颈内动脉支架置入术后动脉夹层修复良好。茎突综合征相关的缺血性卒中应该引起临床医师足够的重视,以降低卒中再发风险。

尺骨茎突Ⅱ型骨折对桡骨远端骨折术后腕关节功能的影响

目的 探讨尺骨茎突Ⅱ型骨折对桡骨远端骨折(DRF)术后腕关节功能的影响。方法 回顾性分析自2019年1月—2021年1月我院收治的桡骨远端骨折接受手术的患者68例,按照有无尺骨茎突Ⅱ型骨折和是否行尺骨茎突内固定手术分为A组(无尺骨茎突Ⅱ型骨折,24例)、B组(有尺骨茎突Ⅱ型骨折无尺骨茎突骨折内固定,21例)、C组(有尺骨茎突Ⅱ型骨折又有尺骨茎突骨折内固定,23例)。记录患者AO分型及手术前、手术后6个月和手术后1年的X线片测量数据,对3组组间患者按照解剖学评分[掌倾角(PTA)、尺偏角(RA)、桡骨茎突高度(RSH))]及Gartlant-Werly(GW)功能评分优良率进行比较。结果 68例患者均进行随访,随访时间为7~12个月,平均随访时间10个月。末次随访时,68例DRF均愈合。3组患者术前、术后6个月及术后1年解剖学评分比较,差异均无统计意义(P>0.05)。A组与B组患者的GW功能评分优良率比较,差异有统计学意义(P<0.05);A组与C组患者的GW功能评分优良率比较,差异无统计学意义(P>0.05);B组与C组患者的GW功能评分优良率比较,差异有统计学意义(P>0.05)。结论 对桡骨远端骨折合并尺骨茎突Ⅱ型骨折,手术行尺骨茎突内固定能够恢复患者下尺桡关节的稳定性,明显改善患者术后腕关节功能,获得更好的预后。

茎突综合征CT测量茎突长度、内倾角SIN值与咽痛关系的临床研究

目的通过对茎突综合征咽痛症状及其影像学特点进行分析讨论,为临床诊治提供参考。方法对2020年~2022年于徐州市中心医院行茎突CT平扫加三维重建确诊茎突过长患者进行回顾性分析。按其临床诊断分为咽痛组和非咽痛组。采用SPSS 25.0分别对两组数据进行统计学分析。对各组的茎突的长度、内倾角、前倾角、h1(茎突长度与内倾角SIN值的乘积)、h2(茎突长度与前倾角SIN值的乘积)分别行t检验,P<0.05即差异有统计学意义。结果咽痛组较非咽痛组茎突的长度、内倾角、h1差异有统计学意义(P<0.05);结论茎突综合征临床表现为咽痛的患者与茎突的长度、内倾角及h1有关,与茎突的前倾角、h2无关。

切开复位骨瓣植骨克氏针内固定治疗陈旧性手舟骨骨折的临床效果及对腕关节功能的影响

目的 探讨切开复位骨瓣植骨克氏针内固定治疗陈旧性手舟骨骨折的临床效果及对腕关节功能的影响。方法 选取2019年1月至2021年1月中国人民解放军联勤保障部队第九〇八医院骨科收治的120例陈旧性手舟骨骨折患者,采用随机数字表法分为观察组和对照组,每组60例。对照组采用克氏针内固定联合松质骨植骨治疗,观察组采用切开复位骨瓣植骨克氏针内固定治疗。比较两组的治疗效果,实验室检查指标,治疗前后的腕关节患者自行评估量表(patient-rated wrist evaluation,PRWE)、上肢简化Fugl-Meyer评定量表(Fugl-Meyer assessment,FMA)、Wolf运动功能测试(Wolf motor function test,WMFT)、Mayo腕关节评分(Mayo wrist score,MWS)、Barthel指数(Barthel index,BI)和改良Rankin量表(modified Rankin scale,mRS)评分,以及术后并发症发生情况。结果 观察组治疗总有效率为93.33%,明显高于对照组的66.67%,差异有显著性(P<0.05)。治疗后观察组的C反应蛋白、血尿酸、红细胞沉降率、白细胞计数、血红蛋白、白细胞介素-6、α1-酸性糖蛋白水平均低于对照组,差异有显著性(P<0.01)。治疗前两组患者的PRWE评分、FMA评分、WMFT评分、MWS评分、BI和mRS评分比较差异无显著性(P>0.05);治疗后两组患者的PRWE评分、mRS评分明显低于治疗前,且观察组明显低于对照组,而FMA评分、WMFT评分、MWS评分、BI明显高于治疗前,且观察组明显高于对照组,差异均有显著性(P<0.05)。观察组的术后并发症发生率(3.33%)明显低于对照组(16.67%),差异有显著性(P<0.05)。结论 切开复位骨瓣植骨克氏针内固定治疗陈旧性手舟骨骨折可显著改善患者腕关节功能、手功能、运动功能及日常生活活动能力,且安全性较高。

放射式冲击波联合威伐光对桡骨茎突狭窄性腱鞘炎的治疗效果

目的:探究放射式冲击波联合威伐光对桡骨茎突狭窄性腱鞘炎的治疗效果。方法:选取本院2020年1月至2022年1月份就诊的80例桡骨茎突狭窄性腱鞘炎患者,依照随机数字表法分为对照组、研究组(n=40),对照组患者应用威伐光进行3次•w^(-1),每次20 min的照射治疗,研究组在对照组照射治疗的基础上加用放射式冲击波进行5 d•次^(-1)的冲击波治疗。比较两组治疗效果,在治疗前及治疗4 w后应用疼痛视觉模拟评分(Visual analogue pain scales,VAS)、腕关节活动度(Range of motion,ROM)评估患者疼痛程度及腕关节活动度,以Quinell病变程度评分、腕关节功能Cooney评分评估患者病变程度及腕关节功能,采用酶联免疫吸附试验检测肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、C-反应蛋白(C-reactive protein,CRP)水平,通过超声波诊断仪检测血流动力学参数收缩期峰值(Peak systolic velocity,PSV)、舒张末期峰值(Enddiastolic peak,DEV)、搏动指数(Pulsation index,PI)、阻力指数(Resistance index,RI)变化。结果:研究组总有效率高于对照组(P<0.05);与治疗前相比,各组患者疼痛评分、腕关节活动度、Cooney评分、Quinell评分均得到明显改善(P<0.05),其中研究组更为显著(P<0.05);与治疗前相比,各组TNF-α、CRP水平、均明显降低(P<0.05),其中研究组更为显著(P<0.05);与治疗前相比,各组PSV、EDV、PI、RI水平均明显升高(P<0.05),其中研究组更为显著(P<0.05)。结论:放射式冲击波联合威伐光可改善桡骨茎突狭窄性腱鞘炎患者临床症状,利于治疗效果提升,缓解疼痛,促进关节功能恢复。

尺骨茎突基底部骨折内固定对腕关节功能的影响

背景:桡骨远端骨折合并尺骨茎突基底部骨折在临床中常见,因其骨折及周围韧带、软骨组织的双重破坏,导致桡尺远侧关节不稳定。以往对尺骨茎突基底部骨折不够重视,往往会出现手术后腕关节疼痛、活动范围受限等并发症的发生,治疗方案存在争议。目的:探讨桡骨远端骨折术中一期行尺骨茎突基底部骨折内固定对腕关节功能恢复的影响。方法:回顾性分析东营市人民医院在2018年6月至2020年12月收治的创伤致桡骨远端合并尺骨茎突基底部骨折并行手术治疗患者40例,桡骨远端骨折治疗方式均为行切开复位内固定。根据在桡骨手术完成后是否行尺骨茎突基底部内固定,将患者分为内固定组和对照组,每组20例。收集患者术前及术后6,12个月随访X射线片测量数据,比较两组患者的尺偏角、掌倾角及桡骨高度;术后1年记录腕关节背伸、掌屈、桡偏、尺偏、旋前、旋后方向的活动范围,应用加特兰德-韦利(Gartland-Werley)评分标准评定疗效。结果与结论:术后随访时,两组患者所测量的腕关节掌倾角、尺偏角、桡骨高度均优于术前(P<0.05),但两组间比较差异无显著性意义(P>0.05);术后1年内固定组腕关节背伸、掌屈、桡偏、尺偏、旋前、旋后方向的活动范围均优于对照组(P<0.05);术后1年内固定组疗效优良率90%,明显高于对照组55%(P<0.05)。结果表明,桡骨远端骨折术中一期行尺骨茎突基底部骨折内固定有利于进一步恢复腕关节功能。

保留扁桃体的茎突截短术治疗茎突综合征

茎突综合征是因茎突过长或形态异常导致周围血管、神经或其他组织受刺激引起的咽部不适、异物感、咽痛、反射性耳痛及头颈痛等症状的一组综合征,易误诊及误治。我科自2010年以来采用保留扁桃体手术治疗茎突综合征共45例,取得满意疗效,现报道如下。

经口低温等离子切除术对茎突过长综合征患者的影响

目的:观察经口低温等离子切除术对茎突过长综合征患者的影响。方法:选取2019年11月—2022年11月尤溪县总医院收治的40例茎突过长综合征患者。根据随机数表法将其分为观察组和对照组,各20例。对照组采用传统经口茎突切除术,观察组采用经口低温等离子切除术。比较两组术后3个月临床疗效、围手术期指标、疼痛情况、并发症。结果:观察组总有效率高于对照组,差异有统计学意义(P<0.05)。观察组手术时间、住院时间均短于对照组,术中出血量少于对照组,术后恢复饮食时间早于对照组,术后1 d视觉模拟评分法(VAS)评分低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,两组比较,差异无统计学意义(P>0.05)。结论:经口低温等离子切除术应用于茎突过长综合征患者的临床治疗中,可有效提高疗效,减少术中出血量,减轻术后疼痛,促进患者尽快恢复。

尺骨茎突骨折及其分型对桡骨远端骨折术后疗效的影响

目的 探讨尺骨茎突骨折与否及其分型对桡骨远端骨折手术的影响。方法 2020年1月~2021年12月在本院治疗的桡骨远端骨折病人92例,根据病人是否合并尺骨茎突骨折以及骨折的Hauck分型标准将其分为非合并组(48例)、合并Ⅰ型组(21例)和合并Ⅱ型组(23例)。收集病人术前、术后6个月和术后1年的掌倾角、尺偏角、桡骨茎突高度恢复等影像学数据及Gartland-Werly评分、握力、臂肩手功能障碍(disabilities of the arm,shoulder and hand,DASH)评分,比较3组的并发症发生率。结果 3组病人术前掌倾角、尺偏角、桡骨茎突高度和关节面平整度差异无统计学意义(P>0.05),3组病人术后6个月及1年掌倾角、尺偏角、桡骨茎突高度和关节面平整度均有不同程度改善,差异有统计学意义(P<0.05),除术后6个月3组的掌倾角、尺偏角存在差异,其余影像学参数术后6个月及1年差异无统计学意义(P>0.05)。3组病人的术后6个月和1年的Gartland-Werly评分比较差异无统计学意义(P>0.05);3组病人术前握力和DASH评分比较差异无统计学意义(P>0.05),术后6个月及1年,3组病人的握力和DASH评分均有不同程度改善,差异有统计学意义(P<0.05),术后1年,与非合并组和合并Ⅰ型组比,合并Ⅱ型组病人的握力和DASH评分恢复较慢,差异有统计学意义(P<0.05)。3组病人均未发生明显的并发症。结论 合并Ⅱ型尺骨茎突骨折会影响桡骨远端骨折术后疗效,合并Ⅰ型尺骨茎突骨折对腕功能影响较小。

再灌注手法治疗桡骨茎突狭窄性腱鞘炎的疗效观察

目的:探究再灌注手法治疗桡骨茎突狭窄性腱鞘炎的临床疗效。方法:选取2020年12月至2021年12月某中医院收治的桡骨茎突狭窄性腱鞘炎患者80例,应用随机数字表法分为对照组和试验组,每组各40例。对照组患者予以双氯芬酸二乙胺乳胶剂涂抹治疗配合腕关节制动,试验组患者在对照组治疗的基础上配合再灌注手法。记录两组患者治疗1周后、治疗后3周的VAS疼痛评分、腕关节尺偏角度、拇指外展角度,全面评价其临床疗效。结果:对比治疗前,治疗1周后、治疗后3周时两组患者的VAS疼痛评分值、腕关节尺偏角度、拇指活动度均有所改善(P<0.05),且试验组患者改善程度优于同时期对照组(P<0.05)。治疗1周后,两组患者临床治疗总有效率差异无统计学意义(P>0.05);试验组治愈率(32.5%)高于对照组治愈率(7.5%)(P<0.05)。治疗后3周回访,试验组患者临床治疗总有效率高于对照组(P<0.01)。结论:再灌注手法在治疗桡骨茎突狭窄性腱鞘炎患者的临床症状方面疗效突出,同时在改善疼痛症状、腕关节活动度的远期疗效方面较对照组更为稳定。

张力带技术固定尺骨茎突对合并Ⅱ型尺骨茎突骨折的C型桡骨远端骨折术后的影响

目的研究C型桡骨远端骨折合并Ⅱ型(Hauck分型)尺骨茎突基底骨折时,克氏针张力带技术切开复位内固定治疗尺骨茎突骨折对桡骨远端骨折内固定术后腕关节功能的影响。方法回顾性分析2018年1月—2021年6月哈尔滨市第五医院骨科收治的87例C型桡骨远端骨折同时合并Ⅱ型尺骨茎突基底骨折患者资料,男性32例,女性55例;年龄28~68岁,平均56.3岁;摔伤40例,高处坠落伤47例。根据尺骨茎突骨折是否固定分为固定组(46例)、对照组(41例),桡骨远端骨折均采用Henry入路切开复位掌侧锁定接骨板内固定,固定组行尺骨茎突切开复位克氏针张力带内固定,对照组给予前臂旋后位经皮自尺骨向桡骨克氏针间接固定。术后1d及1、3、12个月分别记录患者患肢功能参数(掌屈、背伸、旋前、旋后)、手指总主动活动度(total active motion,TAM)及视觉模拟评分(visual analogue scale,VAS),定期复查腕部X线片评估骨折愈合情况,记录骨折愈合时间。末次随访记录患肢腕尺侧疼痛发生率,关节功能评价使用Gartland-Werley功能评分、上肢功能(disability of arm,shoulder and hand,DASH)评分评定患肢功能。结果术后患者均获随访,随访时间13~26个月,平均16.4个月。两组桡骨远端骨折均达骨性愈合,骨折愈合时间比较差异无统计学意义。固定组尺骨茎突均骨性愈合,无畸形愈合或不愈合发生;对照组骨性愈合24例(其中畸形愈合14例),不愈合17例。术后1d、1个月,固定组患肢功能参数(掌屈、背伸、旋前、旋后)均明显优于对照组(P<0.05);术后3个月,固定组掌屈角度明显大于对照组(P<0.05),背伸角度及手指TAM比较差异无统计学意义;术后12个月,两组患者掌屈角度及手指TAM比较差异无统计学意义;术后所有时间节点旋后角度固定组均明显大于对照组(P<0.05);术后1d固定组VAS高于对照组,此后的时间节点固定组VAS均低于对照组,但差异无统计学意义(P>0.05);末次随访显示固定组尺侧旋转疼痛发生率(15.2%,7/46)明显低于对照组(51.2%,21/41,P<0.05),Gartland-Werley评分、DASH评分均优于对照组(P<0.05)。结论对于合并尺骨茎突基底骨折的C型桡骨远端骨折,尺骨茎突骨折切开复位内固定能够明显提高桡骨远端C型骨折术后腕关节功能,降低尺骨茎突畸形愈合、不愈合发生率。