PMC5821999_01
(a) Preoperative computed tomographic image showing enlargement of the left styloid process to approximately 10 mm thick (arrowhead). (a) A computed tomographic image taken 5 years earlier showing enlargement of the styloid process to around 5-7 mm thick (arrow) when the patient was examined for a facial injury.
CRIOT2018-9207264.001.jpg
PMC5821999_01_CRIOT2018-9207264.001.jpg
fig1
Computed tomography (CT) revealed that the left styloid process was connected to the hyoid bone, had a total length of 70 mm, and was approximately 10 mm thick along almost its entire length (Figures 1 and 2). At that time, the styloid process had been approximately 5-7 mm thick, and its enlargement in the subsequent 5 years was evident (Figure 1).
Three-dimensional reconstruction of a computed tomographic image taken preoperatively showing that the left styloid process was fused completely to the hyoid bone and had a total length of 70 mm (arrowheads). It was approximately 10 mm thick along almost its entire length.
CRIOT2018-9207264.002.jpg
PMC5821999_01_CRIOT2018-9207264.002.jpg
fig2
Computed tomography (CT) revealed that the left styloid process was connected to the hyoid bone, had a total length of 70 mm, and was approximately 10 mm thick along almost its entire length (Figures 1 and 2).
Intraoperative findings and the resected styloid process. The styloid process was resected via a transcervical approach. The submandibular gland was removed to ensure a clear field of view. The styloid process (arrowheads) was observed to be continuous with the hyoid bone on the dorsal side of the hypoglossal nerve (arrow), and a 40 mm portion was resected from the site of attachment to the hyoid bone.
CRIOT2018-9207264.003.jpg
PMC5821999_01_CRIOT2018-9207264.003.jpg
fig3
A horizontal skin incision was made in the upper part of the neck, and the submandibular gland was removed to ensure a wide surgical field (Figure 3).
Postoperative computed tomographic image and three-dimensional reconstruction. A good portion of the left styloid process was resected (arrowheads). The styloid process on the right side was also elongated, and the stylohyoid ligament was partially calcified (arrows). Ongoing observation is required.
CRIOT2018-9207264.004.jpg
PMC5821999_01_CRIOT2018-9207264.004.jpg
fig4
Postoperative CT revealed that a good portion of the left styloid process was resected (Figure 4).