Diagnostic difficulties of the styloid process on panoramic radiographs

Introduction. A mineralized and elongated styloid process may be the cause of the symptoms associated with the Eagle’s syndrome. Diagnosis of elongation of this anatomical structure is not easy. Its evaluation is possible clinically and with imaging examinations. For this purpose, the most commonly performed tests are panoramic radiographs, cone-beam computed tomography and computed tomography. Aim of the study. To present examples of a mineralized styloid process in panoramic images according to radiological classification, and to indicate the limitation of the use of quantitative classification resulting from differences in positioning of the patient’s head during examination. Material and methods. Digital panoramic radiographs of patients with an elongated and mineralized styloid process have been selected from the database, classified according to types and presented in the form of an atlas. Analysis of a styloid process shadow on subsequent panoramic radiographs taken in the same patients demonstrated no consistency of the radiographic image. Conclusions. Panoramic examination may only be used to assess the type of mineralization of the styloid process and to determine its approximate length.