Eagle’s Syndrome and the Upper Cervical Connection

What Is Eagle’s Syndrome?

Eagle’s Syndrome is a condition involving elongation of the styloid process or calcification of the stylohyoid ligament complex — thin structures that connect the base of the skull to the hyoid bone in the upper neck.

In most people, the styloid process measures around 2.5 cm. When it extends beyond roughly 3 cm, or when the surrounding ligament becomes calcified, nearby nerves or blood vessels can become irritated or compressed.
These structures sit deep below the ear and jaw and are closely related to the glossopharyngeal, facial, vagus, and trigeminal nerves, as well as branches of the internal carotid artery.

Symptoms

Eagle’s Syndrome can create a wide range of symptoms depending on which structures are affected. Commonly reported issues include:

• Throat or tonsillar pain, often described as sharp or stabbing

• Ear or jaw pain (especially when swallowing, yawning, or turning the head)

• Sensation of a foreign object or tightness in the throat

• Pain radiating into the side of the face or base of the skull

• Headaches or upper neck discomfort

• Dizziness, lightheadedness, or visual changes (especially if vascular compression is involved)

Symptoms may be unilateral or bilateral and can fluctuate over time. In some cases, the condition develops after tonsillectomy, whiplash, or other trauma to the neck.

How It’s Diagnosed

Diagnosis usually involves 3D imaging such as CBCT (cone beam computed tomography) or CT scanning, which allow detailed visualization of both the styloid process length and stylohyoid ligament calcification.
Because these structures are small and sit deep within the neck, conventional X-rays often fail to show them clearly.

The key is correlating imaging findings with a patient’s symptoms and palpatory tenderness.
Many people have calcifications visible on imaging without symptoms, while others have significant irritation despite only moderate elongation — suggesting a strong neuromuscular component to the presentation.

The Upper Cervical Connection

The upper cervical spine (C0–C2) and stylohyoid complex share important muscular and neurological relationships.
Muscles such as the stylohyoid, posterior digastric, and longus capitis attach near the styloid process and occiput — regions that also influence jaw movement, swallowing, balance, and head posture.

When this area becomes irritated or imbalanced, it can contribute to:

• Increased muscle tone and guarding near the upper neck and jaw

• Altered proprioceptive feedback from the cervical spine

• Asymmetric tension on the hyoid and associated ligaments

• Referred pain patterns that mimic ear, throat, or sinus pain

Even when imaging confirms Eagle’s Syndrome, secondary cervical dysfunction can perpetuate or amplify symptoms — especially dizziness, muscle tightness, and postural discomfort.

How Upper Cervical Chiropractic Care Can Help

Upper Cervical Chiropractic care provides an evidence-informed, gentle approach that focuses on restoring neuromuscular balance and motion at the craniocervical junction.
This can help reduce compensatory muscle tension and improve proprioception — key factors in managing complex pain syndromes like Eagle’s.

Potential benefits include:

• Improved joint motion in the upper neck

• Decreased muscle tone in suboccipital and stylohyoid regions

• Better head and jaw posture coordination

• Reduced dizziness and headache-like symptoms

While Upper Cervical care does not alter the physical length of the styloid process or calcification, it may help reduce the surrounding soft-tissue tension and neural irritation that contribute to symptoms — either as a conservative approach or as part of multidisciplinary care with ENT or maxillofacial specialists.

Collaborative Care Matters

Because Eagle’s Syndrome sits at the intersection of ENT, dental, and musculoskeletal systems, a collaborative approach is often most effective.
Upper Cervical chiropractic care can complement medical management by addressing the functional and neuromuscular aspects of the condition — helping improve comfort, posture, and movement while reducing overall irritation in the upper neck region.

References

• Eagle WW. Elongated styloid process: report of two cases. Arch Otolaryngol. 1937.

• Piagkou M, et al. Eagle’s syndrome: a review of the literature. Clin Anat. 2009;22(5):545–558.

• Ghosh LM, Dubey SP. The syndrome of elongated styloid process. Auris Nasus Larynx. 1999;26(2):169–175.

• Ferrario VF, et al. Morphometry of the stylohyoid chain in healthy individuals. Clin Anat. 2007.

• Kumari N, et al. Cervical proprioception and its role in posture and balance. J Bodyw Mov Ther. 2021.