de Araujo, Carlos Eugenio NabucoÂngelo, DavidSanz, DavidCardoso, Henrique José2024-03-142024-03-142023Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology 35 (2023) 518–5222212-5558http://hdl.handle.net/10451/63429© 2023 Asian AOMS, ASOMP, JSOP, JSOMS, JSOM, and JAMI. Published by Elsevier Ltd. All rights reserved. All rights reserved.Stylohyoid syndrome diagnosis is still challenging nowadays and its symptoms can be easily confused with other orofacial pathologies. The aim of this study is to report a case with stylohyoid syndrome, highlighting the symptoms, diagnosis, and surgical treatment, and describing an unusual major complication. Methods: A 48-year-old woman presented to Portuguese orofacial pain department with a history of progressive and unspecified neck pain lasting for 6 years. After clinical investigation, a stylohyoid syndrome was diagnosed based on previous computed tomography (CT) imaging demonstrating progressive calcification of the stylohyoid complex. Results: Surgery by external approach solved the patient's symptoms, but a transient bilateral hypoglossal palsy was found. It was managed conservatively and recovered within 6 weeks. Conclusion: From our knowledge, this is the first study documenting a stylohyoid complex calcification, improving our knowledge about the calcification progression. Depending on surgical and anatomical conditions, the surgeon should consider approaching the contralateral side in a second surgery to avoid major bilateral complications of the parapharyngeal space, like bilateral hypoglossal palsy.engStylohyoid syndromeEagle syndromePainHypoglossal nerve diseasesParapharyngeal spacejournal article10.1016/j.ajoms.2023.03.0082212-5566