Eagles talons: Bilateral Eagle's syndrome and neck trauma. A case report

Eagles syndrome, which is due to calcified stylohyoid ligaments or an elongated styloid process, may manifest as chronic throat pain. It is not usually implicated in trauma. This case report is unique in that we describe firstly a complete bony ring extending from bilateral styloids, and secondly, this abnormality being implicated in serious soft tissue injury. Our patient suffered a blow to the neck during a sports game. While initially asymptomatic, he developed severe neck pain, neck stiffness and odynophagia. Clinical examination of the larynx revealed pharyngeal wall oedema and there was evidence of free air in the retro-pharynx on plain film x-rays. Treatment was initiated in the intensive care unit. He made a complete recovery after 5 days and was discharged with no negative sequelae on follow up. This is a rare finding of bilateral styloid elongation and stylohoid complex ossification forming a complete bony ring around the larynx. Upon retropulsion of this tissue ring, puncture and disruption of the retropharyngeal soft tissues lead to the formation of free air. Prompt airway management is essential in cases such as this that have the potential to compromise the airway if not treated. This case represents a rare finding and an even rarer mechanism of injury.