eagle 's syndrome occurs due to elongation of the sp or calcification of the stylohyoid ligament , which may produce a pain sensation due to the pressure exerted on various structures in the vicinity . the sp is a cylindrical bony projection arising from the lower surface of the petrous portion of the temporal bone . it lies in front of the stylomastoid foramen and its tip projects anteriorly and inferiorly between internal and external carotid arteries and also laterally to the pharyngeal wall and tonsillar fossa . the sp provides the origin attachments for several muscles such as the styloglossus , stylohyoid and stylopharyngeus muscles and for ligaments such as the stylohyoid and stylomandibular ligaments . important structures surrounding the sp include facial and hypoglossal nerves , the occipital artery and the posterior belly of the digastric muscle laterally and the lingual , facial , superficial temporal , maxillary , and internal carotid arteries , internal jugular vein and the stylomandibular ligament medially . the purpose of this study was to evaluate the length of sp in the dry skulls present in the department . the elongated sp and the ossified stylohyoid ligament can compress the structure in close vicinity , leading to symptoms like sore throat , dysphasia , otalgia , the sensation of a foreign body in the throat , facial pain radiating to the ear or along the mandible , and head and neck mimicking neuralgic pain . the study has been conducted in 45 dry skulls at the department of anatomy , sree balaji dental college and hospital . it was observed in 4 skulls belonging to that , sp was elongated in 1 , bilaterally , and 3 , unilaterally . the skulls with the elongated processes were photographed . among the skulls , sp was elongated unilaterally in 3 skulls and bilaterally in 1 skull . among the skulls , sp was elongated unilaterally in 3 skulls and bilaterally in 1 skull . the sp can be elongated bilaterally or unilaterally , however unilateral elongation of the sp is more frequent . ossification of the stylohyoid ligament occurs with differing frequency and may be as low as 24% or as high as 84.4% but may be asymptomatic . in the eagle 's syndrome , elongated sp  is a term used since the publication by eagle in reports concerning findings in both dentomaxillofacial and ear  nose  throat patients . eagle 's definition was :  the normal sp measures between 2.5 cm and 3 cm . his method of measurement was not described , but his examples showed lateral radiographs of the skull . eagle described the syndrome and stated that the normal sp is approximately 2.75 cm and any sp beyond that may be considered elongated . he described the classic syndrome as persistent pain in the pharynx , aggravated by swallowing with the pain frequently referred to the ear on the side of the elongated sp . he also noticed increased salivation , hesitancy and difficulty in swallowing , gagging and a foreign body sensation . in the first group , symptoms are characterized by pain located in the areas of distribution of the fifth , seventh , eighth , ninth and tenth cranial nerves . it is associated in most cases with tonsillectomy that may have been performed many years earlier . pain following tonsillectomy is presumably created by stretching or compressing the nerve or nerve endings of cranial nerves in the tonsillar fossa either during healing or due to scar formation . the elongated sp can be palpated by inserting a finger orally along the occlusal plane posterior to the region of the tonsillar fossa . confirmation is made with radiographs showing an elongated sp or mineralization of the stylohyoid complex . the second type , the carotid artery syndrome , usually is not associated with tonsillectomy . the carotid artery syndrome is caused by mechanical irritation of the sympathetic nerve tissue in the walls of the internal and/or external carotid artery by the tip of the sp or the ossified ligament . there is no significant sex predilection in occurrence of mineralization of the sp ; however , symptoms are more common in females . the symptoms in eagle 's syndrome range from mild discomfort to acute neurologic and referred pain . these may include : pain in the throat , sensation of a foreign body in the pharynx , difficulty in swallowing , otalgia , headache , pain along the distribution of the external and internal carotid arteries , dysphasia , pain on cervical rotation , facial pain , vertigo , and syncope . the sp may develop inflammatory changes or impinge on the adjacent arteries , on sensory nerve endings leading to the symptoms . diagnosis can usually be made on physical examination : by digital palpation of the sp in the tonsillar fossa , which exacerbates the pain . relief of symptoms with injection of local anesthetic into tonsillar fossa relieving the pain can be used as a diagnostic tool . over the years , authors have given much pathogenic relevance to the length of sp , as well as to the shape and position in suggesting the etiology of painful syndromes . however , not all elongated sps are symptomatic , since some sps of normal length can also lead to the syndrome . clinicians must be aware of the anatomy of the sp , which may aid them in establishing a clinical diagnosis .
the styloid process ( sp ) on the temporal bone is a highly variable formation . 
 the normal length of the sp ranges from 20 to 30 mm . in spite of its being normally distributed in the population , 
 sps could be divided into two groups  short sps with > 20 mm and long sps with < 20 mm in length . 
 the sp is often denoted as elongated when it is longer than 30 mm or 33 mm . 
 these dimensions , based on early reports , do not respect the natural variation of the sp . 
 the aim of this study is to investigate the natural variation of the length of the sp .