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196 REVISTA BRASILEIRA DE OTORRINOLARINGOLOGIA 68 (2) PARTE 1 MARÇO/ABRIL 2002 http://www.sborl.org.br / e-mail: [email protected] Eagle Syndrome: surgical treatment evaluation Resumo / Summary Introdução: A apófise estilóide é uma projeção óssea que se origina na porção timpânica do osso temporal. O aumento desta ou a ossificação do ligamento estilohióideo pode originar uma série de sintomas como disfagia, odinofagia, dor facial, otalgia, cefaléia, zumbido e trismo. Este conjunto de sintomas associado à presença da apófise estilóide alongada é conhecido como Síndrome de Eagle. Objetivo: Relatar um grupo de quatro pacientes com Síndrome de Eagle, bem como discutir a apresentação clínica e o tratamento mais adequado desta doença. Forma de estudo: Clínico retrospectivo. Material e método: Realizado estudo clínico retrospectivo de quatro pacientes, operados no HSPE-FMO e HSPM de São Paulo, no período de junho de 1998 a junho de 2001. O tratamento cirúrgico foi a opção terapêutica escolhida, com a retirada da apófise estilóide alongada. Foi avaliada a evolução clínica no pós- operatório. Resultados: Dos quatro pacientes, três eram do sexo feminino e um do sexo masculino, com idade variando de 38 a 68 anos e com média etária de 57,25 anos. A apófise estilóide alongada foi encontrada e operada em ambos os lados em 50% dos casos. Houve remissão completa dos sintomas em três pacientes, com melhora parcial no outro paciente. Conclusão: Esta doença deve ser considerada em pacientes com sintomas de disfagia, odinofagia, dor facial, otalgia, cefaléia, zumbido e trismo. O tratamento cirúrgico para pacientes que apresentam a apófise estilóide alongada com sintomas compatíveis com a Síndrome de Eagle é a melhor forma de conduzir estes casos, sendo a via de abordagem externa a que oferece mais segurança e que possibilita uma ressecção mais completa. Romualdo Suzano Louzeiro Tiago 1 , Marcílio Ferreira Marques Filho 2 , Clícia Adriana Santos Maia 3 , Osvaldo Fonseca Souza Santos 4 Palavras-chave: síndrome de Eagle, ligamento estilohióideo, ossificação. Key words: Eagles syndrome, ligament stylohyoid, ossification. Síndrome de Eagle: avaliação do tratamento cirúrgico 1 Mestre em Otorrinolaringologia e Cirurgia de Cabeça e Pescoço pela UNIFESPEPM. Médico Assistente do Setor de Cirurgia de Cabeça e Pescoço do Serviço de Otorrinolaringologia do HSPEFMO-São Paulo/SP. Médico Assistente do Serviço de Otorrinolaringologia do HSPM de São Paulo/SP. 2 Pós-Graduando (Doutorado) do Curso de Pós-graduação em Otorrinolaringologia e Cirurgia de Cabeça e Pescoço da UNIFESPEPM. 3 Pós-Graduanda (Mestrado) do Curso de Pós-graduação em Otorrinolaringologia da Faculdade de Ciências Médicas da Sta. Casa de São Paulo. 4 Médico-Residente (R2) do Serviço de Otorrinolaringologia do HSPM de São Paulo/SP. Instituição: Setor de Cirurgia de Cabeça e Pescoço do Serviço de Otorrinolaringologia do Hospital do Servidor Público Estadual Francisco Morato de Oliveira São Paulo/SP. Serviço de Otorrinolaringologia do Hospital do Servidor Público Municipal de São Paulo/SP. Endereço para correspondência: Romualdo S. L. Tiago Rua Estado de Israel 493, ap 51 Vila Clementino São Paulo CEP 04022-001 Tel. (0xx11) 5084.7725 E-mail: [email protected] Artigo recebido em 26 de novembro de 2001. Artigo aceito em 17 de janeiro de 2002. Introduction: The styloid apophysis is an osseous outgrowth originating in the tympanum portion of the temporal bone. Its growth, or the ossification of the stylohyoid ligament, may cause a series of symptoms, such as dysphagia, odynophagia, facial pain, otalgia, cephalea, tinnitus and trismus. This set of symptoms associated to the presence of an elongated styloid aphophysis is known as the Eagle syndrome. Aim: To report on a group of four patients with Eagle syndrome, as well as to discuss the clinical presentation and the most suitable treatment of this disease. Study design: Clinical retrospective. Material and Method: A retrospective clinical study of four patients who were submitted to surgery at the HSPE-FMO (State Public Servants Hospital) of São Paulo, and at the HSPM (Municipal Public Servants Hospital) of the city of São Paulo, in the period from June, 1998, to June, 2001. The surgical treatment was the therapeutic option selected, with the removal of the elongated styloid aphophyses. The clinical evolution was assessed during the postoperative period. Results: Of the four patients, three were females and one a male, ages ranging from 38 to 68 years, with an average age of 57.25 years. The elongated styloid aphophyses were found and operated in both sides in 50% of the cases. Full remission of the symptoms occurred in three of the patients, and a partial improvement was observed in the other patient. Conclusion: This disease should be considered when the patient presents symptoms, such as dysphagia, odynophagia, facial pain, otalgia, cephalea, tinnitus and trismus. Surgical treatment is the best form of conducting such cases with patients presenting elongated styloid aphophysis and symptoms compatible with the Eagle syndrome, with the external approach being the one that offers greater safety and allows for a more complete resection. ORIGINAL ARTICLE ARTIGO ORIGINAL Rev Bras Otorrinolaringol. V.68, n.2, 196-201, mar./abr. 2002 ««

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