Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Surgical treatment of a patient with carotid atherosclerosis and stylohyoid syndrome

Authors: I.N. Shchanitsyn 1, Yu.I. Titova 1, N.V. Sazonova 1, D.Yu. Sumin 1, T.A. Ionova 1, O.Yu. Lukin 1, S.P. Bazhanov 1, I.V. Larin 2

Company:
1 Research Institute of Traumatology, Orthopedics and Neurosurgery, Razumovsky Saratov State Medical University, Saratov, 410002, Russian Federation
2 Regional Clinical Hospital, Saratov, 410053, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2020-17-1-24-31

UDC: 616.133-004.6

Link: Clinical Physiology of Blood Circulaiton. 2020; 17 (1): 24-31

Quote as: Shchanitsyn I.N., Titova Yu.I., Sazonova N.V., Sumin D.Yu., Ionova T.A., Lukin O.Yu., Bazhanov S.P., Larin I.V. Surgical treatment of a patient with carotid atherosclerosis and stylohyoid syndrome. Clinical Physiology of Circulation. 2020; 17 (1): 24–31 (in Russ.). DOI: 10.24022/1814-6910-2020-17-1-24-31

Received / Accepted:  12.12.2019/19.12.2019

Full text:  

Abstract

Eagle syndrome (stylohyoid syndrome) is defined as symptomatic elongation of the styloid process or calcification of the stylohyoid and stilomandibular ligament. Compression of the carotid artery because of overgrown styloid processes is described in the literature. It may cause damage to the wall of carotid artery and result in cerebrovascular ischemic event. However, carotid artery compression associated with the hyoid bone is extremely rare. In this article, we report a case of ischemic stroke in a young patient because of carotid atherosclerosis and compression by horns of the hyoid bone treated by surgical resection and carotid endarterectomy at both sides. CT-angiography is an extremely valuable imaging tool in diagnosing Eagle syndrome and in relationship carotid artery to head and neck bone structures. Hyoid bone abnormality may be an important and underrecognized cause of young adult carotid artery compression and ischemic stroke.

References

  1. Eagle W.W. The symptoms, diagnosis and treatment of the elongated styloid process. Am. Surg. [Internet]. 1962; 28: 1–5.
  2. . Chuang W.C., Short J.H., McKinney A.M., Anker L., Knoll B., McKinney Z.J. Reversible left hemispheric ischemia secondary to carotid compression in Eagle syndrome: surgical and CT angiographic correlation. Am. J. Neuroradiol. [Internet]. 2007; 28 (1): 143–5.
  3.  Farhat H.I., Elhammady M.S., Ziayee H., AzizSultan M.A., Heros R.C. Eagle syndrome as a cause of transient ischemic attacks. J. Neurosurg. [Internet]. 2009; 110 (1): 90–3. DOI: 10.3171/2008.3.17435
  4. Kawahara I., Ozono K., Fujimoto T., Hirose M. Internal carotid artery stenosis associated with hyoid bone: can hyoid bone be a risk factor for acute cerebrovascular syndrome? No Shinkei Geka [Internet]. 2016; 44 (10): 835–41. DOI: 10.11477/mf.1436203387
  5. Taguchi A., Ohba S., Itoh Y., Ohshita J., Yonezawa K. A case of carotid artery stenosis associated with repetitive stimulation of the hyoid bone. No Shinkei Geka. 2018; 46 (9): 811–8.
  6. Renard D., Azakri S., Arquizan C., Swinnen B., Labauge P., Thijs V. Styloid and hyoid bone proximity is a risk factor for cervical carotid artery dissection. Stroke. [Internet]. 2013; 44 (9): 2475–9. DOI: 10.1161/STROKEAHA.113.001444
  7. Raser J.M., Mullen M.T., Kasner S.E., Cucchiara B.L., Messe S.R. Cervical carotid artery dissection is associated with styloid process length. Neurology. [Internet]. 2011; 77 (23): 2061–6. DOI: 10.1212/WNL. 0b013e31823b4729
  8. Muthusami P., Kesavadas C., Sylaja P.N., Thomas B., Harsha K.J., Kapilamoorthy T.R. Implicating the long styloid process in cervical carotid artery dissection. Neuroradiology. 2013; 55 (7): 861–7. DOI: 10.1007/ s00234-013-1186-1
  9. Aldelaimi T.N., Boskani S.W., Ali S.M., Mahmud P.K. Eagle syndrome. J. Craniofac. Surg. [Internet]. 2017; 28 (3): e214–6. DOI: 10.1097/SCS.0000000000003399
  10. Шумилина М.В., Алшибая М.М., Луспаронян В.М., Дорофеев А.В., Гецадзе Г.Г. Особенности инструментальной диагностики посттравматической диссекции внутренней сонной артерии и ее спонтанного излечения. Клиническая физиология кровообращения.2018; 15 (4): 267–76. DOI: 10.24022/ 1814-6910-2018-15-4-267-276 [Shumilina M.V., Alshibaya M.M., Lusparonyan V.M., Dorofeev A.V., Getsadze G.G. Features of instrumental diagnosis of post-traumatic dissection of the internal carotid artery and its spontaneous cure. Clinical Physiology of Circulation.2018; 15 (4): 267–76 (inRuss.). DOI: 10.24022/1814-6910-2018-15-4-267-276 ]
  11. Li Z., Hua Y., Yang J., Li J. Ultrasound evaluation of transient ischemic attack caused by styloid process elongation: a case report. Front Neurol. 2019; 10: 26. DOI: 10.3389/fneur.2019.00026
  12. Dewan M.C., Morone P.J., Zuckerman S.L., Mummareddy N., Ghiassi M., Ghiassi M. Paradoxical ischemia in bilateral Eagle syndrome: a case of falselocalization from carotid compression. Clin. Neurol. Neurosurg. [Internet]. 2016; 141: 30–2. DOI: 10.1016/ j.clineuro.2015.12.004
  13. Radak D., Tanaskovic S., Kecmanovic V., Babic S., Popov P., Gajin P. Bilateral Eagle syndrome with associated internal carotid artery kinking and significant stenosis. Ann. Vasc. Surg. [Internet]. 2016; 34 (271): e15–18. DOI: 10.1016/j.avsg.2016.01.015
  14. Abdelaziz O.S., Ogilvy C.S., Lev M. Is there a potential role for hyoid bone compression in pathogenesis of carotid artery stenosis? Surg. Neurol. 1999; 51 (6): 650–3. DOI: 10.1016/s0090-3019(99)00022-1
  15. Kumagai N., Enomoto Y., Miyai M., Egashira Y., Nakayama N., Iwama T. A rare case of symptomatic carotid stenosis caused by mechanical stimulation by thyroid cartilage and frequent swimming. J. Stroke Cerebrovasc. Dis. 2019; 28 (3): 699–701. DOI: 10.1016/j.jstrokecerebrovasdis.2018.11.006
  16.  Аракелян В.С., Гидаспов Н.А., Шумилина М.В., Куличков П.П. Компрессия экстракраниального отдела внутренней сонной артерии элементами подъязычной кости и щитовидного хряща в сочетании со стенозом атеросклеротического генеза. Анналы хирургии. 2019; 24 (3): 202–7. DOI: 10.24022/1560-9502-2019-24-3-201-207 [Arakelyan V.S., Gidaspov N.A., Shumilina M.V., Kulichkov P.P. Compression of extracranial part of the internal carotid artery by the hyoid bone and the upper horn of the thyroid cartilage in combination with atherosclerotic stenosis. Russian Journal of Surgery. 2019; 24 (3): 202–7 (in Russ.). DOI: 10.24022/1560-9502-201924-3-201-207 ]
  17. Torikoshi S., Yamao Y., Ogino E., Taki W., Sunohara T., Nishimura M. A staged therapy for internal carotid artery dissection caused by vascular Eagle syndrome. World Neurosurg. 2019; 129: 133–9. DOI: 10.1016/ j.wneu.2019.05.208
  18. Hooker J.D., Joyner D.A., Farley E.P., Khan M. Carotid stent fracture from stylocarotid syndrome. J. Radiol. Case Rep. 2016; 10 (6): 1–8. DOI: 10.3941/ jrcr.v10i6.1618
  19. Naito Y., Yamazaki K. Perioperative management of Eagle syndrome complicated by carotid artery dissection. J. Anesth. 2014; 28 (2): 291–3. DOI: 10.1007/ s00540-013-1713-6

About Authors

  • Ivan N. Shchanitsyn, Cand. Med. Sc., Senior Researcher, Cardiovascular Surgeon; orcid.org/0000-0003-0565-5172
  • Yuliya I. Titova, Radiologist; orcid.org/0000-0001-5738-9780
  • Nadezhda V. Sazonova, Ultrasonic Diagnostician; orcid.org/0000-0003-1401-1918 Dmitriy Yu. Sumin, Radiologist; orcid.org/0000-0002-0788-5863
  • Tat'yana A. Ionova, Cand. Med. Sc., Ultrasonic Diagnostician; orcid.org/0000-0003-2410-4309
  • Oleg Yu. Lukin, Anesthesiologist; orcid.org/0000-0002-1658-8529
  • Sergey P. Bazhanov, Dr. Med. Sc., Neurosurgeon; orcid.org/0000-0001-9474-9095
  • Igor' V. Larin, Endovascular Surgeon; orcid.org/0000-0001-7979-3071

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