Type:
Educational Exhibit
Keywords:
Anatomy, Head and neck, Digital radiography, CT, Diagnostic procedure, Normal variants, Calcifications / Calculi, Hyperplasia / Hypertrophy
Authors:
J. Vidal González, F. Jiménez Aragón, M. calvo garcia; Ciudad Real/ES
DOI:
10.26044/ecr2019/C-2773
Findings and procedure details
-Methods of Radiographic Study of the Estilohyoid Apparatus:
The diagnosis is based on a detailed clinical history and a correct physical examination along with the relevant complementary radiological tests.
Most cases are casual radiological findings in search of cervical or rhinopharyngeal pathology.
The stylohyoid apparatus can be observed in different and varied radiographic projections,
from the most basic and conventional to the most advanced of three dimensional diagnosis.
The orthopantomography is the most useful of all the projections and the most widely used,
although it also has great drawbacks,
such as the magnification of the structures or the distortion of the apophysis.
The measurement of its length is quite uncertain since the superposition of structures prevents an adequate visualization of the basal part of the apophysis,
in addition,
the position of the head influences the distortion of the image.
Despite its disadvantages,
there is now a consensus on the acceptance of panoramic radiography as the best conventional radiographic technique to visualize the styloid processes,
also the current digital techniques allow a much clearer and more accurate visualization.
However,
there are authors who recommend making other projections that allow the study of the apophysis in two dimensions.
They claim that using two well-combined two-dimensional techniques such as a lateral skull radiograph and a Towne projection,
both the length and the angulation of the styloid processes can be measured.
Spiral computed tomography (CT) with subsequent three dimensional reconstruction is the method of choice for exact determination of the localisation and size of a megastyloid.
Computed tomography scans can provide an accurate evaluation of the styloid process in relation to the other head and neck structures,
of its length and angulation. It is useful in the surgical planning also.
Among radiological investigations,
orthopantamotomography or a skull x ray with anteroposterior and lateral projections are used for initial evaluation followed by non-contrast computed tomography with three dimensional reconstruction to confirm the diagnosis.
When mechanical vascular compression is suspected,
CT angiography may demonstrate stenosis of the carotid artery by an elongated styloid process.