When a common complaint reveals an uncommon diagnosis – The Eagle syndrome
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2016 |
| Outros Autores: | , , , |
| Tipo de documento: | Artigo |
| Idioma: | por |
| Título da fonte: | Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) |
| Texto Completo: | https://doi.org/10.32385/rpmgf.v32i1.11692 |
Resumo: | Introduction: The Eagle syndrome is characterized by the elongation of styloid process. This provides attachment for many important neurovascular structures and can lead to a broad spectrum of symptoms. The most common symptoms include odynophagia and a sensation of a foreign body. It can also cause dysphagia, headache, syncope, or even transient ischemic attacks. The diagnosis is difficult as the symptoms may be attributed to other diseases. Case report: We describe the case of a 35-year-old female with persistent odynophagia for 8 months, with multiple consultations with her family doctor and the local emergency department. Physical examination revealed oropharyngeal erythema. Endoscopy and pharyngeal exudate were normal. The patient was referred to an otolaryngology consultation, but no cause was found. With persistent odynophagia and anxiety due to a lack of a diagnosis, computerized tomography of the pharynx was requested. This revealed asymmetry of the styloid process and the Eagle syndrome was diagnosed. Conservative management was suggested, but due to refractory symptoms, the patient was referred to stomatology. After consultation in hospital, the complaints of pain improved with anti-inflammatory therapy. The patient is currently followed in hospital with annual monitoring. Comment: Although the Eagle syndrome is rare, it should be considered in patients with chronic cervicofacial pain, especially when this is refractory to treatment. Otherwise, it may lead to incorrect diagnosis, to consumption of health resources, and to physical and emotional stress for the patient. The family doctor has a role to play in recognition this syndrome since the symptoms are commonly encountered in daily clinical practice. |
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When a common complaint reveals an uncommon diagnosis – The Eagle syndromeQuando uma queixa comum revela um diagnóstico incomum – Síndroma de EagleEagle SyndromeStyloid ProcessOdynophagia.Síndroma de EagleApófise EstilóideOdinofagia.Introduction: The Eagle syndrome is characterized by the elongation of styloid process. This provides attachment for many important neurovascular structures and can lead to a broad spectrum of symptoms. The most common symptoms include odynophagia and a sensation of a foreign body. It can also cause dysphagia, headache, syncope, or even transient ischemic attacks. The diagnosis is difficult as the symptoms may be attributed to other diseases. Case report: We describe the case of a 35-year-old female with persistent odynophagia for 8 months, with multiple consultations with her family doctor and the local emergency department. Physical examination revealed oropharyngeal erythema. Endoscopy and pharyngeal exudate were normal. The patient was referred to an otolaryngology consultation, but no cause was found. With persistent odynophagia and anxiety due to a lack of a diagnosis, computerized tomography of the pharynx was requested. This revealed asymmetry of the styloid process and the Eagle syndrome was diagnosed. Conservative management was suggested, but due to refractory symptoms, the patient was referred to stomatology. After consultation in hospital, the complaints of pain improved with anti-inflammatory therapy. The patient is currently followed in hospital with annual monitoring. Comment: Although the Eagle syndrome is rare, it should be considered in patients with chronic cervicofacial pain, especially when this is refractory to treatment. Otherwise, it may lead to incorrect diagnosis, to consumption of health resources, and to physical and emotional stress for the patient. The family doctor has a role to play in recognition this syndrome since the symptoms are commonly encountered in daily clinical practice.Introdução: A Síndroma de Eagle caracteriza-se pelo alongamento da apófise estilóide do osso temporal, a qual comprime as estruturas neurovasculares adjacentes abrangendo, por isso, um amplo espectro de sintomas. Os mais comuns incluem odinofagia e sensação de corpo estranho, mas também disfagia, otalgia, cefaleia, síncope ou até mesmo acidente isquémico transitório. O diagnóstico não é fácil, sendo necessário um alto índice de suspeição, dado que os sintomas podem ser atribuídos a outras patologias. Descrição do caso: Relata-se o caso de uma utente de 35 anos de idade, com odinofagia esquerda persistente com cerca de oito meses de evolução e com múltiplas recorrências a consultas agudas na unidade de saúde familiar e no serviço de urgência. Ao exame objetivo destacava-se apenas rubor da orofaringe. Realizou zaragatoa de exsudado faríngeo e endoscopia digestiva alta que não revelaram alterações. Foi referenciada à consulta de otorrinolaringologia; porém, teve alta por não ter sido detetada patologia. Por persistência de odinofagia intensa, e revelando já alguma ansiedade face à ausência de diagnóstico, foi solicitada uma tomografia computorizada da faringe que evidenciou assimetria das apófises estilóides, considerando a possibilidade de síndroma de Eagle. Optou-se pelo tratamento conservador mas, por refratariedade da sintomatologia, foi referenciada para a consulta de estomatologia. À data da consulta hospitalar apresentava já melhoria das queixas álgicas com terapêutica anti-inflamatória, mantendo o seguimento hospitalar com vigilância anual. Comentário: Apesar de a síndroma de Eagle ser uma patologia rara, deve ser equacionada nos pacientes que apresentam dor cervico-facial crónica, sobretudo quando refratária ao tratamento. Caso contrário, poderá conduzir, erradamente, ao diagnóstico de outras patologias, ao consumo de recursos de saúde e ao desgaste físico e emocional do doente. Assim sendo, o médico de família apresenta um papel importante no reconhecimento desta síndroma, uma vez que os sintomas são comummente encontrados na sua prática clínica diária.Associação Portuguesa de Medicina Geral e Familiar2016-02-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.32385/rpmgf.v32i1.11692https://doi.org/10.32385/rpmgf.v32i1.11692Portuguese Journal of Family Medicine and General Practice; Vol. 32 No. 1 (2016): Revista Portuguesa de Medicina Geral e Familiar; 65-9Revista Portuguesa de Medicina Geral e Familiar; Vol. 32 Núm. 1 (2016): Revista Portuguesa de Medicina Geral e Familiar; 65-9Revista Portuguesa de Medicina Geral e Familiar; Vol. 32 N.º 1 (2016): Revista Portuguesa de Medicina Geral e Familiar; 65-92182-51812182-517310.32385/rpmgf.v32i1reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAPporhttps://rpmgf.pt/ojs/index.php/rpmgf/article/view/11692https://rpmgf.pt/ojs/index.php/rpmgf/article/view/11692/11249Direitos de Autor (c) 2016 Revista Portuguesa de Medicina Geral e Familiarinfo:eu-repo/semantics/openAccessFernandes, Dina NovaisSilva, AntónioMiranda, AdrianaSousa, LuisSequeira, José2024-09-17T11:59:57Zoai:ojs.rpmgf.pt:article/11692Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T18:52:01.412309Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse |
| dc.title.none.fl_str_mv |
When a common complaint reveals an uncommon diagnosis – The Eagle syndrome Quando uma queixa comum revela um diagnóstico incomum – Síndroma de Eagle |
| title |
When a common complaint reveals an uncommon diagnosis – The Eagle syndrome |
| spellingShingle |
When a common complaint reveals an uncommon diagnosis – The Eagle syndrome Fernandes, Dina Novais Eagle Syndrome Styloid Process Odynophagia. Síndroma de Eagle Apófise Estilóide Odinofagia. |
| title_short |
When a common complaint reveals an uncommon diagnosis – The Eagle syndrome |
| title_full |
When a common complaint reveals an uncommon diagnosis – The Eagle syndrome |
| title_fullStr |
When a common complaint reveals an uncommon diagnosis – The Eagle syndrome |
| title_full_unstemmed |
When a common complaint reveals an uncommon diagnosis – The Eagle syndrome |
| title_sort |
When a common complaint reveals an uncommon diagnosis – The Eagle syndrome |
| author |
Fernandes, Dina Novais |
| author_facet |
Fernandes, Dina Novais Silva, António Miranda, Adriana Sousa, Luis Sequeira, José |
| author_role |
author |
| author2 |
Silva, António Miranda, Adriana Sousa, Luis Sequeira, José |
| author2_role |
author author author author |
| dc.contributor.author.fl_str_mv |
Fernandes, Dina Novais Silva, António Miranda, Adriana Sousa, Luis Sequeira, José |
| dc.subject.por.fl_str_mv |
Eagle Syndrome Styloid Process Odynophagia. Síndroma de Eagle Apófise Estilóide Odinofagia. |
| topic |
Eagle Syndrome Styloid Process Odynophagia. Síndroma de Eagle Apófise Estilóide Odinofagia. |
| description |
Introduction: The Eagle syndrome is characterized by the elongation of styloid process. This provides attachment for many important neurovascular structures and can lead to a broad spectrum of symptoms. The most common symptoms include odynophagia and a sensation of a foreign body. It can also cause dysphagia, headache, syncope, or even transient ischemic attacks. The diagnosis is difficult as the symptoms may be attributed to other diseases. Case report: We describe the case of a 35-year-old female with persistent odynophagia for 8 months, with multiple consultations with her family doctor and the local emergency department. Physical examination revealed oropharyngeal erythema. Endoscopy and pharyngeal exudate were normal. The patient was referred to an otolaryngology consultation, but no cause was found. With persistent odynophagia and anxiety due to a lack of a diagnosis, computerized tomography of the pharynx was requested. This revealed asymmetry of the styloid process and the Eagle syndrome was diagnosed. Conservative management was suggested, but due to refractory symptoms, the patient was referred to stomatology. After consultation in hospital, the complaints of pain improved with anti-inflammatory therapy. The patient is currently followed in hospital with annual monitoring. Comment: Although the Eagle syndrome is rare, it should be considered in patients with chronic cervicofacial pain, especially when this is refractory to treatment. Otherwise, it may lead to incorrect diagnosis, to consumption of health resources, and to physical and emotional stress for the patient. The family doctor has a role to play in recognition this syndrome since the symptoms are commonly encountered in daily clinical practice. |
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2016 |
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por |
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https://rpmgf.pt/ojs/index.php/rpmgf/article/view/11692 https://rpmgf.pt/ojs/index.php/rpmgf/article/view/11692/11249 |
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Portuguese Journal of Family Medicine and General Practice; Vol. 32 No. 1 (2016): Revista Portuguesa de Medicina Geral e Familiar; 65-9 Revista Portuguesa de Medicina Geral e Familiar; Vol. 32 Núm. 1 (2016): Revista Portuguesa de Medicina Geral e Familiar; 65-9 Revista Portuguesa de Medicina Geral e Familiar; Vol. 32 N.º 1 (2016): Revista Portuguesa de Medicina Geral e Familiar; 65-9 2182-5181 2182-5173 10.32385/rpmgf.v32i1 reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia instacron:RCAAP |
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