Temporal styloid process fracture

Case contributed by Yuliia Solodovnikova
Diagnosis certain

Presentation

The military patient suffered a mine explosion, and traumatic cervical spine distortion, with an isolated fracture of the temporal bone styloid process. The patient presented with a severe headache and pain in the projection of the styloid process on the left during yawning, swallowing, and turning the head to the right. As a result of trauma, the patient was thrown away by the blast wave, fell, and experienced hyperextension of the neck with torsion of the head to the right. The examination revealed pain during palpation in the region of the left pterygopalatine fossa and a diminution of gag reflex on the left.

Patient Data

Age: 25 years
Gender: Male

3D volume rendering and CT bone windows show a left temporal styloid process fracture.

Case Discussion

Length of the styloid processes:

  • 26.3 mm on the right

  • 26.25 mm on the left

These meet the criteria of the morphologic variant type 1 (less than 30 mm).

There is a downward dislocation of the lower part of the left styloid process according to the level of the transverse process of atlas compared to the right one. The patient's presentation, results of clinical examination, mechanism of trauma, and CT findings allow us to confirm the diagnosis of temporal styloid process fracture, despite its rarity in a case of normal length.

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