Non Surgical Treatment of Eagle's Syndrome - A Case Report -
A 36-year-old female patient visited the hospital complaining of otalgia that had started approximately 3 years previously. The pain had been recurring 2 to 3 times a month, and there were no abnormalities in hermedical history. No particular abnormalities were observed in the otoscopy performed by the otolaryngology department. The pain was characterized as a needle-like, piercing paininside the ear, and it had worsened one week before the patient's visit tothe hospital.\nIn the physical examination, tenderness was felt in the left mastoid process. Although the styloid process was not felt, it caused pain when the tonsils were touched, and the patient complained of severe pain when turning herneck to the left. The VAS score was 8.\nA radiograph () and CT scan () were taken for differential diagnosis of Eagle's syndrome. The results showed that the length of the right styloid process was approximately 18 mm, within the normal range, whereas the left was approximately 30 mm, which was elongated compared with the right. The disease was explained to the patient and surgical treatment was recommended, but the patient refused. Hence, conservative treatment was selected and performed. Oral medication was begun with administration of gabapentin (Gabapentin®, Dong-APharm Co., Seoul, Korea) 300 mg/d, tianeptine (Stablon®, Jeil Pharm Co., Seoul, Korea) 1.5 mg/d, and tramadol hydrochloride 37.5 mg/acetaminophen 325 mg (Paramacet®, Dong-APharm Co., Seoul, Korea) 3 tablets/d. In addition, approximately 1 ml of triamcinolone 10 mg combined with 0.3% mepivacaine 3 ml was injected once inthe tonsils and tender areas. Afterwards, a stellate ganglion block was performed on the left side once a week for approximately 4 weeks.\nThe symptoms gradually improved following the drug administration and injection, and after two weeks, the VAS score had fallen to 2.\nAs the pain did not worsen during the 3-month monitoring period, drug administration was stopped. The patient agreed to consider surgical treatment in case of pain recurrence, and treatment was concluded.