Evaluation of postoperative pain after tonsil-sparing styloidectomy

Eur Arch Otorhinolaryngol. 2020 Jul;277(7):2011-2015. doi: 10.1007/s00405-020-05930-y. Epub 2020 Mar 25.

Abstract

Purpose: Styloidectomy is the mainstream treatment for Eagle's syndrome when conservative treatment fails. However, the clinical efficacy of tonsil-sparing styloidectomy remains controversial. This study aimed to evaluate postoperative pain after tonsil-sparing styloidectomy in patients with Eagle's syndrome.

Methods: This retrospective study enrolled 14 patients who underwent tonsil-sparing styloidectomy (TSS group) and 22 patients who underwent traditional tonsillect-styloidectomy (TTS group). Pain was evaluated using the 11-point numeric rating scale (NRS-11) at the following time points: on admission, 1 day after the operation, 3 days, postoperatively, 1 week postoperatively, 2 weeks, postoperatively, and 3 months, postoperatively.

Results: The postoperative course was uneventful in both groups. Pain with movement was significantly reduced 3 months, postoperatively (1.28 ± 1.1), compared with the preoperative baseline level (4.78 ± 0.9) (P < 0.001). There was no significant difference in the rate at which pain decreased between the TSS group (n = 9/14; 64.3%) and the TTS group (n = 17/22; 77.3%) (P = 0.396). One week postoperatively, resting pain in the TSS group (4.36 ± 0.7) was significantly lower than that in the TTS group (5.41 ± 0.8) (P = 0.001); pain with movement in the TSS group (5.00 ± 0.8) was significantly lower than that in the TTS group (5.86 ± 0.7) (P = 0.002). Two weeks postoperatively, resting pain in the TSS group (1.14 ± 0.4) was also significantly lower than that in the TTS group (1.73 ± 0.6) (P = 0.003).

Conclusions: Tonsil-sparing styloidectomy is a safe and effective modality for treating Eagle's syndrome. Although there was no significant difference in surgical risk or long-term outcomes between tonsil-sparing styloidectomy and traditional tonsillect-styloidectomy, tonsil-sparing styloidectomy can alleviate perioperative pain.

Keywords: Eagle’s syndrome; Pain; Prognosis; Styloidectomy; Tonsil-sparing styloidectomy.

MeSH terms

  • Humans
  • Ossification, Heterotopic*
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / etiology
  • Palatine Tonsil* / surgery
  • Retrospective Studies
  • Temporal Bone