Eagle syndrome has an incidence of 18% in all cases facial pain; only a small part of this percentage is clinically manifest.

With the present work, we want to stress the importance of knowing this syndrome, even if it is rare, in order to make a correct differential diagnosis and to avoid giving wrong diagnoses. We describe the case of a 46-year-old patient with a positive medical history of chronic tonsillitis and continuous foreign body sensation in the left tonsillar region.


After an otolaryngological examination, a left monolateral tonsillectomy was performed.

However, after this surgery the foreign body sensation did not decrease, but worsened and was accompanied by symptoms of pain during deglutition and by a monolateral cephalalgia in the left temporal region, which is poorly responsive to analgesics.

The palpation of the tonsillary region gives the patient pain to the left area. The instrumental examinations (OPT) revealed a long styloid process.

We gave the diagnosis of Eagle syndrome and suggested surgery, but the patient refused it. Eagle syndrome or stylohyoid syndrome was first described in 1937. It is more frequent in females and usually clinically manifests after 30 years of age.


It can be caused either by the presence of a particularly long styloid process (over 35 mm) or by an anomalous calcification process of the stylohyoid ligament. A frequent favoring factor is tonsillectomy.

During diagnosis, particular attention should be given to the case history, in order to understand the localization, the irradiation, the frequency and the onset of pain. Digital palpation of the tonsillar cavity is fundamental too. In the positive cases, palpation causes exacerbation of pain. Among the instrumental examinations, Rx OPT is particularly useful.


Facial pain is one of the most common manifestations of pain.


The intensity of pain often reaches such levels to compromise the quality of the patient?s life. In this field, it is essential to make a correct differential diagnosis, in order to avoid giving wrong diagnoses. Therefore, in patients coming to our attention complaining this type of symptomatology, it is advisable to practice a digital exploration of the tonsillar cavity and, in case, to administer further radiological examinations.


F. Inchingolo 1-4, A. D. Inchingolo1, M. Tatullo 2, M. Marrelli 4 , A.M. Inchingolo 3, F. Carbotti 1, A. Palladino 1, M. De Carolis 1, V. Angelini 1 , A.D. Inchingolo1, G. Dipalma1-4
Department of Odontostomatology and Surgery, University of Bari, Bari, Italy
Department of Odontostomatology and Surgery, University of Milano, Milano, Italy
Department of Maxillofacial Surgery, Calabrodental Srl, Crotone, Italy