The stylohyoid muscle inserts via a split tendon onto the body of the hyoid bone, with the tendon splitting to allow the intermediate tendon of the digastric to pass through. This arrangement is analogous to the digastric pulley but involves the stylohyoid tendon wrapping around the digastric tendon at the hyoid.
The stylohyoid tendon is involved in Eagle syndrome pathology, where elongation of the styloid process places abnormal traction on the stylohyoid complex. Calcification of the stylohyoid ligament-tendon complex is the basis of Eagle syndrome and is visible on panoramic dental X-ray and CT. The tendon is released during styloidectomy for Eagle syndrome. Its split insertion around the digastric tendon is a recognised anatomical teaching point in neck dissection.
Progressive calcification of the stylohyoid tendon and ligament producing throat pain, dysphagia, and ear pain from adjacent structure compression, treated by surgical styloidectomy via transcervical or transoral approach.
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