BACKGROUND The elongation of the styloid process is historically associated with two variants of the Eagle syndrome. The classic one, mainly characterized by pain and dysphagia, and the carotid variant characterized by pain and sometimes by cerebral ischemia. We observed a further variant characterized by a styloid elongation coursing adjacent to the transverse process of C1, causing significant compression of the internal jugular vein. METHODS We reviewed all the cases of Eagle syndrome, including the jugular variant, admitted in our Hospital in the last six years. We compared symptomatology, associated comorbidities and imaging. Data were statistically analyzed. RESULTS Overall 23 patients were admitted to the Hospital for symptomatic elongation of the styloid process, 11 male and 12 females. The jugular variant of the Eagle syndrome is clinically delineated by significant differences, as compared to the classic variant and carotid variants. Headache was the more prominent symptom (p < .009) as well as a documented peri-mesencephalic hemorrhage was the more significant comorbidity (p < .0003). The group classic-carotid variant was characterized by ipsilateral pain respect to the jugular variant (p < .0003). CT angiography with venous phase extended to the neck veins and imaging reconstruction is highly recommended as imaging technique, complemented by color-Doppler ultrasound. CONCLUSIONS The elongation of the styloid process may have different paths which creates compression on the surrounding anatomical structures. There may be a possible association of jugular impingement by an elongated styloid process with symptoms. TRIAL REGISTRATION Protocol n°45-2013.

中文翻译：

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鹰颈综合症。

背景技术茎突的延长在历史上与Eagle综合征的两个变体有关。经典的一种，主要表现为疼痛和吞咽困难，而颈动脉的变异体则表现为疼痛，有时还表现为脑缺血。我们观察到另一种变异，其特征是茎突伸长与C1的横向过程相邻，导致颈内静脉明显受压。方法我们回顾了过去六年来我院收治的所有Eagle综合征病例，包括颈椎变体。我们比较了症状，相关合并症和影像学。对数据进行统计分析。结果共有23例因茎突突症状而住院的患者，男11例，女12例。与经典变体和颈动脉变体相比，Eagle综合征的颈椎变体在临床上具有明显差异。头痛是最突出的症状（p <.009），而有记录的中脑周围性出血是更明显的合并症（p <.0003）。组经典颈动脉变异的特征是同侧疼痛相对于颈椎变异（p <.0003）。强烈建议将静脉相延伸至颈静脉的CT血管造影和成像重建作为成像技术，并辅以彩色多普勒超声。结论茎突的伸长可能具有不同的路径，这会在周围的解剖结构上产生压迫。延长的茎突过程可能会引起颈椎撞击和症状。