Clinical Snapshot
Eagle Syndrome as a Rare Cause of Acute Pharyngeal Hemorrhage
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A 22-year-old patient presented on an emergency basis with a 4-day history of sore throat that had suddenly worsened after an abrupt head movement and was associated with progressive swelling, shortness of breath, muffled voice, and aphagia. Clinical examination revealed livid swelling of the right retrotonsillar space extending into the hypopharynx, without supraglottic obstruction (Figure a). The patient was afebrile and admitted to hospital in stable respiratory condition. Contrast-enhanced computed tomography showed active arterial bleeding in the parapharyngeal space with hematoma formation (Figure b). Emergency angiography identified the right occipital artery with a pseudoaneurysm as the source of bleeding, which was successfully treated with coil embolization. The cause was assumed to be vascular injury due to an elongated styloid process (Eagle syndrome). Following an uncomplicated hospital course, the patient was discharged free of symptoms. Resection of the styloid process was planned for a later date. Eagle syndrome, named after the person who first described it, is caused by an elongated styloid process or a calcified stylohyoid ligament and most commonly causes chronic sore throat, odynophagia, or globus sensation. Arterial injuries are extremely rare. In addition to analgesic measures, treatment usually includes transoral resection of the elongated styloid process; alternatively, transcervical resection is also possible.
Dr. L. Bühning, Prof. Dr. A. Dietz, Dr. M. Sorge, Klinik und Poliklinik für HNO/Plastische Chirurgie, Universität Leipzig, laura.buehning@medizin.uni-leipzig.de
Conflict of interest statement: The authors declare that no conflict of interest exists.
Translated from the original German by Christine Rye.
Cite this as: Bühning L, Dietz A, Sorge M: Eagle syndrome as a rare cause of acute pharyngeal hemorrhage. Dtsch Arztebl Int 2026; 123: 8b. DOI: 10.3238/arztebl.m2025.0176
