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///2018 Abstract Details
2018 Abstract Details2019-08-02T15:57:01-05:00

A Parturient withEagle Syndrome

Abstract Number: T4C-4
Abstract Type: Case Report/Case Series

Jeffrey P Cardinale MD, PhD1 ; Liane Germond MD2

Eagle Syndrome (ES) is a rare and often difficult diagnosis that involves styloid elongation which may give rise to intense facial pain, headaches, dysphagia, otalgia and trismus amongst other rarer complications. We present the case of a 33-year-old G2P0 female with a history of morbid obesity status-post gastric bypass, diabetes mellitus and recently diagnosed ES associated with dysphagia and ear, jaw and neck pain. Otolaryngology workup around 5 months post-conception did not feel urgent surgical repair of her right styloid was required. The patient was seen in our pre-operative clinic with concerns for general anesthesia due to occipital pain and scotoma upon head movement. There was also concern for difficult neuraxial placement due to the patient's BMI of 53 and scoliosis. When the patient arrived to labor and delivery in active labor, a combined spinal-epidural was placed easily for labor analgesia. Several hours later she was brought urgently to the operating room for primary cesarean section under epidural anesthesia for recurrent late and variable decelerations on the fetal monitor. The surgery was completed without any complications and she was discharged home on post-operative day three. Since discharge, the patient has had a CT scan demonstrating a mildly elongated right styloid and is awaiting surgical correction. While rare and generally not associated with anesthetic complications, head and neck manipulation can cause significant discomfort and there are known cases of difficult intubations and carotid dissections associated with ES. Familiarity and a more cautious and prepared approach to patients presenting with ES, especially within the obstetric population where intubation complications are much more prevalent, will serve this patient population well in future encounters.

SOAP 2018