So if you follow the Eagles Syndrome Group on FB, one lady just posted her recent CT scan and CT scan from 6+ years ago. The styloid from ~1cm went to ~4 cm.
In my opinion, based on the 3d model, that was either calcification of some ligament or a muscle, not the styloid that grew longer, and looks similar to what I have been highlighting in some of this group’s 3d models.
So my conclusion is that the styloid process perhaps doesn’t grow after reaching certain age (25y.o.? 18y.o? Puberty?) but some structure(s) attached to it start calcifying and eventually start looking like an elongated styloid process. Though in many cases there is what seems to be a fine line between the sharply define contour of the original short SP and the extending calcification.
You always come up with interesting but plausible theories @vdm. This is another one that is a definite possibility. The only thing I would question is how would styloid regrowth, which some people have experienced, be explained if the styloids stop elongating or ligaments stop calcifying at some point? Would it be the same idea you suggested? Also, I wonder if they stop growing at a certain age, why would it be so many years before ES symptoms develop for some people? Could it be the age at which growth stops varies widely among individuals?
By design the styloid serves as an anchor for some muscles and ligaments. If, during the styloidectomy, some of the ligaments/muscles remain attached to the skull base or re-attach themselves to nearby structures, I’d assume they get calcified and “re-grow”?
Perhaps I need to watch more styloidectomy videos to properly understand what muscles and ligaments are released and at which point.
On the second thought, I think I was wrong. The styloids obviously can regrow, because they are bones cut in the middle.
When the bone is broken, e.g. an arm or leg is broken, the bone keeps growing until it meets the other end of the bone. Simply because the tissue in the middle of the bone is different from the “terminus” end. I remembered that there are even some special surgeries to lengthen one’s legs by cutting the femur/tibia bones and holding them stretched apart for a while to make a small gap in between, which is eventually filled by growing bone mass.
The question then comes… When the styloid is resected and let’s say regrows, what terminates it’s growth then, given there are no “terminus” point anymore? I know at least one of the surgeons (Dr Old???) does/used to add a small extra tissue patch at the resection point to prevent regrowth.
Maybe it doesn’t have a terminus point if it re-grows…perhaps it would keep growing? I have this image of a ppatient with a 20cm styloid growing right down there body & Canadian doctors still saying you don’t need surgery for that!
I’m sure there was a research paper where the growth of a SP was studied, I think in a Japanese patient…
