Stylalgia is a pain syndrome occurring in connection with elongated or malpositioned styloid process.
The charcteristic symptoms were chronic throat pain during swallowing with referred otalgia or referred pain to cheek or lower part of neck
associated with foreign body sensation in throat. Movements of head or act of deglutition initiates or increases the pain
The diagnosis of stylalgia is based on symptoms, palpation of enlarged styloid process intraorally in the tonsillar region and elicitation of similar nagging throat pain or pain in the neck or foreign body sensation in the throat.
Confirmation of enlarged styloid process is always done by radiological examination of styloid process per orbital view.

Eagle's Syndrome

Possible symptoms include

Classic eagle syndrome is present on only one side, however, rarely, it may be present on both sides.

In vascular Eagle syndrome, the elongated styloid process comes in contact with the internal carotid artery below the skull. In these cases, turning the head can cause compression of the artery or a tear inside the blood vessel, which restricts blood flow and can potentially lead to a transient ischemic attack (TIA) or stroke.

Eagle syndrome occurs due to elongation of the styloid process or calcification of the stylohyoid ligament. However, the cause of the elongation hasn’t been known clearly. It could occur spontaneously or could arise since birth. Usually normal stylohyoid process is 2.5–3 cm in length, if the length is longer than 3 cm, it is classified as an elongated stylohyoid process.

Diagnosis is suspected when a patient presents with the symptoms of the classic form of "Eagle syndrome" e.g. unilateral neck pain, sore throat or tinnitus. Sometimes the tip of the styloid process is palpable in the back of the throat.

The diagnosis of the vascular type is more difficult and requires an expert opinion. One should have a high level of suspicion when neurological symptoms occur upon head rotation.

Symptoms tend to be worsened on bimanual palpation of the styloid through the tonsillar bed. They may be relieved by infiltration of lidocaine into the tonsillar bed. Because of the proximity of several large vascular structures in this area this procedure should not be considered to be risk free.

Imaging is important and is diagnostic. Visualizing the styloid process on a CT scan with 3D reconstruction is the suggested imaging technique.The enlarged styloid may be visible on an orthopantogram or a lateral soft tissue X ray of the neck.

Treatment
In both the classic and vascular form, the treatment is surgical. A partial styloidectomy is the preferred approach. Repair of a damaged carotid artery is essential in order to prevent further neurological complications.Regrowth of the stylohyoid process and relapse being a common occurrence is debateable.