Vertigo Caused by an Elongated Styloid Process-A Case Report

A 73-year-old male complained of vertigo and/or faintness during mastication. X-ray films showed an elongated styloid process hooked at the tip. A CT scan showed the styloid process compressing the internal jugular vein medially at the level of the first cervical vertebra. The equillibrium test revealed vertical nystagmus downward in the supine position with the head rotated to the right. Positional testing with the head in the hanging position could not be performed because of the sensation of faintness. These findings led us to the conclusion that the styloid process compressed the internal jugular vein, decreasing the outflow from the heart, and resulting in reduced blood flow to the brain giving rise to vertigo. The stylohyoid syndrome consists of neck pain, dull ache in the pharynx, earache and tinnitus, etc, but not vertigo. This is a rare case.