Eagle syndrome and vascular complications-a systematic review.

Vascular complications occurring in Eagle syndrome are seldom described. The aim of this study was to systematically review the occurrence, characteristics, and management outcomes of vascular complications occurring in Eagle syndrome. A systematic review was conducted with a search in several databases. The research question was "What characterizes Eagle syndrome with vascular complications and how should it be managed?" The initial search yielded 4145 results; 150 of these were included, reporting a total of 231 patients with vascular complications. Arterial impingement (67.5%) was more frequent than venous impingement (32.5%). The most frequent consequence of arterial impingement was stroke (46.8%), while for venous impingement it was chronic headache (68%). Seventy-nine patients underwent styloidectomy as initial treatment: 78.5% of the patients were cured and 19.0% improved, while only 2.5% showed a recurrence. On the other hand, among the 106 patients treated medically without initial styloidectomy, only 24.5% of the patients were cured, 28.3% improved, and 47.2% had a recurrence. The association of symptoms of classic Eagle syndrome with neurovascular symptoms should prompt clinicians to consider this diagnosis and to measure the styloid length. Styloidectomy is the treatment of choice to obtain the best cure rate and reduce recurrence.