When a common complaint reveals an uncommon diagnosis – The Eagle syndrome

Detalhes bibliográficos
Autor(a) principal: Fernandes, Dina Novais
Data de Publicação: 2016
Outros Autores: Silva, António, Miranda, Adriana, Sousa, Luis, Sequeira, José
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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spelling 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.
publishDate 2016
dc.date.none.fl_str_mv 2016-02-01
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https://rpmgf.pt/ojs/index.php/rpmgf/article/view/11692/11249
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2016 Revista Portuguesa de Medicina Geral e Familiar
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rights_invalid_str_mv Direitos de Autor (c) 2016 Revista Portuguesa de Medicina Geral e Familiar
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dc.publisher.none.fl_str_mv Associação Portuguesa de Medicina Geral e Familiar
publisher.none.fl_str_mv Associação Portuguesa de Medicina Geral e Familiar
dc.source.none.fl_str_mv 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
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