Re-envisioning the Concept of Styalgia and Styloidectomy.

Introduction: Prevalence of elongated styloid process (SP) is 4% and only 4-10% of these patients are symptomatic. In this study morphology was assessed among the patients unlike the dry skulls. Comparison of elongation and angulation of SP between the case and control groups, as well as symptomatic correlation was done. This study also imparts information regarding symptomatic outcomes following medical and surgical management. Objective: To compare the anatomical variations in SP morphology and symptomatology in patients with and without stylalgia. Methods: A prospective study was done over a period of 1.5 years on 84 participants. The required details were recorded. Radio-imaging was done through Towne's and lateral view of skull X-rays to measure length, as well as medial and anterior angulations. Pain assessment was done with the visual analogue scale before and after conservative or surgical managements. Results: Mean age of participants was 37.2 ± 8.8 years, with a female preponderance. The most common symptom was recurrent oropharyngeal pain (67.8%). Elongated SP was observed in the case group with a mean length of 4.07 cm, compared with 2.36 cm in controls. The mean medial angulation of the SP was of 21.28° in the case group and of 16.77° in the controls. Anterior angulation in the case group was of 32.19°, compared with 21.74° in the controls. A statistically significant difference was noted in in length, medial and anterior angulations in the case group when compared with controls. Conclusion: Symptomatic elongated SP is a complex condition for many patients. Its precise identification will aid in early recovery from symptoms. Surgical management showed better symptomatic outcomes. Level of Evidence: Level 3.