Post-Tonsillectomy Chronic Throat Pain: A Radiological Evaluation for Elongated Styloid Process

Open Access

Abstract

Background: Chronic throat pain following tonsillectomy is an under-recognized clinical concern that may be associated with elongation of the styloid process, a condition related to Eagle syndrome. Radiological assessment plays a pivotal role in identifying elongated styloid processes in symptomatic patients, yet limited prospective data exist in the Bangladeshi population. Objective: To evaluate the prevalence of elongated styloid process among patients presenting with chronic neck pain after tonsillectomy using radiological imaging. Methods & Methods: This prospective cohort study was conducted at Bangladesh Medical College and Hospital, Dhaka, and SENTH of SAHIC from January 2023 to December 2025. A total of 73 patients with a history of tonsillectomy and persistent neck pain for more than three months were enrolled using purposive sampling. Clinical evaluation was followed by radiological assessment with digital X-ray and/or computed tomography to measure styloid process length. Data were analyzed using SPSS version 23.0. Results: Among the 73 participants, 46 (63.0%) were female, and 27 (37.0%) were male, with a mean age of 34.8 ± 9.6 years. Radiological evaluation revealed an elongated styloid process in 41 patients (56.2%). Bilateral elongation was observed in 24 (32.9%) cases, while unilateral elongation was found in 17 (23.3%). A significant association was observed between an elongated styloid process and the severity of neck/throat pain (p=0.01). Conclusion: Elongated styloid process is a common radiological finding in patients with post-tonsillectomy chronic throat pain. Routine radiological screening may facilitate early diagnosis and appropriate management, improving patient outcomes.