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Alan Brewster, DC, ACP, Christine Theodossis, DC, DCCJP, Laura Orndorff, DC, RT(R)
Journal of Upper Cervical Chiropractic Research ~ April 29, 2025 ~ Pages 16-21
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Abstract
Background: The styloid process, due to its proximity to various neurological and vascular structures, may compress and compromise those structures if sufficiently elongated or if calcification of the stylohyoid ligament is present (styloid elongation/stylohyoid calcification, SESC). A styloid process is typically considered elongated at greater than 30mm, but the novel criterion of proximity to the C1 transverse process may provide a more clinically relevant and reliable classification.
Methods: Two consecutive samples of 100 nasium radiographs (n=200) were selected from patient records at a chiropractic college clinic. Independent evaluators experienced in radiographic analysis reviewed one group each, noting the presence of SESC that extends inferiorly to below the C1 transverse process.
Results: The prevalence of SESC extending down to the level of the C1 transverse process, either unilaterally or bilaterally, was observed at 84.3% overall. Prevalence was slightly higher in males.
Conclusion: SESC extending to the level of the C1 transverse processes was found to be far more prevalent than elongated styloids report in the literature using the current >30mm standard and offers a potentially more clinically significant evaluation.
Keywords: elongated styloid process, ESP, stylohyoid ligament, chiropractic, vertebral subluxation, Eagle syndrome
