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Eagles syndrome, sore throat, ear pain, neck swelling, dysphagia. Causes and treatment ?

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ENT Specialist
Practicing since : 1991
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Hi. a few years ago, I saw a dentist who did a panoramic xray. when he viewed it, he said that i had eagle's syndrome (i have never heard of it prior to then). he didn't say anything else. last year, i noticed a swollen gland on the right side of my throat (near my collar bone) and a bump/lump on the right side of my throat above my XXXXXXX XXXXXXX i've had intermittent swelling on the right side of my throat since then. i saw an ent who did a ct scan which showed small thryroid cyst on the left side, which did not concern him. he checked my vocal cords and said they were fine and I had no cancer. by the time i did see him, the swelling in my neck had subsided and my neck looked "normal" although i had taken pictures and he clearly saw the swelling, which was why he sent me for ct scan. at the time, i was having problems with feeling like something was stuck in my throat so i was constantly clearing my throat and had symptoms of dysphasea. i had an endoscopy which came back normal. i saw him again this year because i've continued to have swelling and was fortunate that the swelling was happening during the visit with him. he sent me for an ultra sound which came back unremarkable. last year, he said i could have a thyroglossal duct cyst or a laryngeal cyst. this year, he said he question goiter, but said that would show bilaterally, not unilaterally, therefore, didn't believe it was a goiter. i asked him about the eagles syndrome and showed him the xray the dentist had taken. he dismissed that idea. after seeing him about a month ago, he said he didn't know what the problem was and that i should see him again next year to monitor the "bump/lump". i have experienced hoarseness, swallowing issues, sore throat that feels like it's on the right side of my throat, right ear pain (dull). i am 40 yo F, smoke 1 ppd x 23 yrs, h 5'9, w, 255. surgery on r knee x 7, last surgery in december 2010. the ent dr i saw said he did not believe i had cancer because i wouldn't present with intermittent swelling. can you give me any suggestions? thank you
Posted Wed, 25 Apr 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 1 hour later

Thank You for your query.

1. In Eagle's Syndrome, the styloid process 'elongates' as the stylohoid ligament calcifies / ossifies and 'shortens'. There should be a definite enlargement compared to the left side demonstrated on your panoramic x-ray and CT scan. This causes compression of the glossopharyngeal nerve and leads pain akin to a sore throat, ear pain , dysphagia. However it does not cause any swelling in the neck.

2. Cancerous swellings do usually not reduce in size and have a history of ever increasing size. The same holds good for cancerous lymph nodes.

3.An intermittent swelling on the side of the neck above the Adam's XXXXXXX has to be investigated for the following:
a) Laryngocele: An external or mixed laryngocele is an air sac which intermittently appears in this position through the thyrohyoid membrane. This would cause all the above symptoms including hoarseness. Though these are usually benign, they can be associated with a small cancer situated in the laryngeal ventricle which acts like an air valve. This should be ruled out in your case, since you have a history of 23 pack years of smoking.

b) Hyoid bursitis: It is an inflammation of the subhyoid bursa and can cause a cystic swelling in the upper lateral neck.
c) An esophageal diverticulum, hence i would recommend a Barium swallow study.

4. Thyroglossal cysts are usually in the midline.

You may discuss this with your treating physicians and investigate accordingly.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

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