Fracture of the styloid process associated with the mandible fracture
A 27-year-old male patient had an interpersonal fight and received a blow with a blunt object on the left side of the face. Patient presented to the Department of Oral and Maxillofacial Surgery with the chief complaints of inability to chew and pain in left retromandibular region. On presentation patient was fully conscious, oriented and vitals were stable. There was no history of loss of consciousness. Also there was history of bleeding after trauma form the left ear. On local examination of the head and neck region there was diffuse swelling with retromandibular fossa and lower third of the face in the mental region on the left side. There was extreme tenderness in the region between the left posterior border of the mandible and the mastoid process and condylar movements were indistinct. Intra-orally there was occlusal step present with the lower premolar region, which correlated well with the extra-oral tenderness with left inferior border of the mandible in the mental region.\nEven though it is uncommon to find ipsilateral condylar and parasymphysis fracture of the mandible. But the history of blunt injury with positive history of bleeding from the ear on the same side and indistinct condylar movements with preauricular swelling were suggestive of ipsilateral fracture of condyle and parasymphysis of the mandible. A clinical diagnosis of fracture of ipsilateral condyle and Parasymphysis of the mandible was made. But an orthopantamogram revealed intact condylar process on either side. It also showed moderately elongated styloid process (ESP) on both sides and a suspected fracture of left SP []. A computerized tomography scan was ordered which confirmed the presence of elongated SP on either side and an undisplaced fracture of left SP [Figures and ]. Pain and tenderness around the left ear was correlated with fracture of the SP on the same side.\nMandibular fracture was treated with open reduction and internal fixation. SP fracture was managed conservatively with neck collar and analgesics. Inter-maxillary fixation was maintained for 2 weeks post-operatively. Post-operative period was uneventful. Patient was asymptomatic and occlusion remained intact after 1½ year follow-up.