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Program

WSU Medical School

Training Level

Medical Student

Institution

Wayne State University

Abstract

Eagle syndrome is a rare elongation of the styloid process or calcification of the stylohyoid ligament. Most cases are asymptomatic but compression on head and neck structures can result in dysphagia and neck pain. Etiology may be related to surgical scar tissue but is unclear due to limited case presentation. A 52 year-old male with surgical history of tonsillectomy presented to the hospital with shortness of breath. He developed sudden onset dyspnea and pink frothy sputum. He desaturated and was put on BiPaP in the ED. Chest X-ray revealed flash pulmonary edema and he was admitted for hypoxic respiratory failure. Within three days his status was complicated by bacteremia and atrial fibrillation and cardiology recommended a trans-esophageal echo before discharge. He was unable to tolerate TEE at the bedside and anesthesia with intubation was planned instead. Three intubation attempts failed despite fiberoptic and glidescope assistance and limited neck and laryngeal tissue mobility were noted. Follow-up imaging of CT neck/chest without contrast showed complete calcified left stylohyoid ligament extending from the styloid process to the hyoid bone. Post-procedure he endorsed dysphagia with both solids and liquids and voice change. Swallow studies and flexible laryngoscopy showed oropharyngeal dysphagia and silent aspiration with nectar thick liquids. He has not been able to tolerate NGT and has been placed on TPN pending gastrostomy tube. This case shows a rare symptomatic presentation of Eagle Syndrome with CT visualization and contributes to gathering more information as to the etiology and clinical presentation of the condition.

Presentation Date

5-2020

Eagle Syndrome Presenting in a Patient as Dysphagia and Failed Intubations

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