The role of vascular laboratory in the management of Eagle syndrome

Eagle syndrome is caused by an elongated styloid process or calcified stylohyoid ligament. The stylocarotid variant with neurologic symptoms is rare and presents a diagnostic challenge. Patients may present with transient ischemic attacks, syncope, or less well defined symptoms like episodic dizziness. We report use of vascular laboratory testing in the management of Eagle syndrome. In one patient, on Doppler ultrasound examination of the ipsilateral temporal artery, the signal was lost with provocative neck flexion. In another patient, transcranial Doppler ultrasound showed blunting of the middle cerebral artery with provocative maneuvers. We used perioperative transcranial Doppler ultrasound to assess the effectiveness of styloid resection.