Surgery for styloid process

Styloid process is also known as styloid process syndrome. It was first reported by Eagle in 1937, so it was named Eagle syndrome. The disease is not uncommon, the cause is more complicated, but mainly the stem process is too long, the system is in the process of development, the abnormal ossification of the styloid process. The styloid process is located at the bottom of the humeral rock, from the anterior inner side of the stem hole, and is elongated and bone-shaped. The distal end extends to the medial and anterior and posterior. The normal styloid process has a length of about 2.16 to 2.52 cm. When the styloid process is too long, different symptoms are caused by the different regions of the end extension. The disease is more common in adults, most of the symptoms start slowly, the history of the disease varies, from a few days, months to years, clinical manifestations are also different, more likely to miss the diagnosis. Styloid process is mainly treated with surgery, truncation and long styloid process. The operation usually has two paths, such as oropharynx and external neck. The outer diameter of the neck is suitable for the long styloid process and the lateral deflection is significant. In the tonsil fossa, it is not possible to clearly touch the styloid process or although it is accessible but the position of the styloid is deep. The specific surgical method and path should be determined according to the specific circumstances of the patient. Treatment of diseases: styloid syndrome Indication Surgery for styloid process is suitable for: 1. One side of pharyngeal pain or pharyngeal foreign body sensation, which can induce or aggravate symptoms when swallowing or head position changes. 2, palpation in the tonsil fossa, fingers can be licked and hard strips or thorns. 3, the positive and lateral X-ray examination of the styloid process confirmed the abnormal position, shape and length of the styloid process. If you have the condition, you can choose spiral CT to display the position of the styloid process in three dimensions, and the shape and length are better. 4, the symptoms of sore throat are significant, urgently require surgery. Contraindications 1, with tonsil surgery contraindications. 2, although a variety of examinations can confirm that the styloid process is too long, but the patient has no symptoms or mild symptoms. 3, pharyngeal discomfort and tonsil foreign body sensation, pharyngeal paraesthesia, glossopharyngeal neuralgia and pharyngeal tumors are not identified. Preoperative preparation 1, detailed medical history and physical examination, paying particular attention to the history of bleeding with or without abnormality and the history of exposure to infectious diseases, general anesthesia should be chest X-ray, children should pay attention to the size of the thymus. 2, do blood routine, platelet count, clotting time check, liver function, Australian anti-inspection, patients over the age of 40 should do ECG. 3. Check the nose and mouth. If there is an infection in the nose, mouth, nasopharynx or sinus, do it after proper treatment. 4, on the day of surgery fasting and forbidden water, patients with local anesthesia surgery, before the night before surgery, take appropriate amount of sedative before bedtime, subcutaneous injection of atropine 0.5mg half an hour before surgery, antibiotics may be applied as appropriate. Patients undergoing general anesthesia should be prepared preoperatively according to general anesthesia requirements. Rest should be adequate 1 day before surgery. 5, do a good job of thinking, explain the purpose of surgery and precautions, eliminate the patient's nervousness, and strive for patient cooperation. Surgical procedure First, the stem process truncation - oropharyngeal path 1. Excision of the tonsils on the long side of the styloid process. 2, styloid positioning: after the tonsil fossa wound completely hemostasis, touch the finger in the socket to determine the position of the end of the styloid process. 3. Separation of styloid processes: On the end of the established styloid process, the pharyngeal epithelium is cut longitudinally 1.0-1.5 cm (the fascia and muscles, etc., which are covered on the styloid process, are directly connected to the styloid surface. Cut or cut the styloid process, the lingual ligament of the lingual bone, insert it from the end of the styloid process with a circular curette, and apply pressure to the root to separate the soft tissue around the styloid process and push out the styloid as much as possible. 4. Truncate the styloid process, clamp the end of the styloid process with a vascular clamp, and then use the bite bone to cut off the upper part of the exposed styloid process and remove the broken end. 5, check the wound surface, completely stop bleeding, suture the incision with a thin thread. Second, the stem process truncation - neck outer diameter road 1. Incision: Along the anterior border of the sternocleidomastoid muscle, an oblique incision is made from the tip of the mastoid to the level of the hyoid bone, and the skin, subcutaneous tissue and platysma are sequentially cut. 2, explore the styloid process: blunt separation of the deep fascia of the neck, retract the incision, pull the carotid sheath to the rear, determine the position of the large angle of the hyoid bone and the lingual body, and thus look for the two abdominal muscles and the styloid bone Muscles, along the styloidal musculature, probe the end of the styloid process, the body and the root. 3. Separation of the styloid process: the periosteum at the end of the styloid process is cut, and the ligament of the styloid process and the ligament of the styloid process are cut at the end of the styloid process, and the end of the styloid process is separated by a circular curette. Push away. 4, truncated styloid process: the end of the styloid process with a vascular clamp, and then cut off with a bite bone, remove the stump tip. 5, check the wound surface, completely stop bleeding, rinse the cavity with Qingdamycinmycin saline, suture the wound layer by layer, cover sterile gauze, pressure dressing. complication 1, bleeding. 2, infection. 3. Trauma. 4. Tonsillary debris.