[Shilopodilingual syndrome as a cause of carotid artery dissection (literature review)].

RELEVANCE: There are more and more publications about cases of damage to the internal carotid artery (ICA) in stylohyoid syndrome Eagle. It is assumed that extravasal compression can lead to delamination, the formation of pseudoaneurysms or thrombosis of the ICA. Several retrospective studies have been conducted on the role of stylohyoid syndrome in the development of ICA dissection.

THE PURPOSE: Summarizing current data on clinical manifestations and treatment options, as well as analyzing studies on ICA dissection against the background of stylohyoid syndrome.

MATERIAL AND

METHODS

An electronic search of publications in the databases PubMed (Medline), Google Scholar and RSCI (Elibrary) was conducted without restrictions on the publication status of the article in accordance with the PRISMA criteria. In the analysis of clinical cases, the following parameters were taken into account: gender, age, side of the lesion, length of the styloid process (SP) and ossification of the stylohyoid ligament, the presence of a provoking factor, symptoms of the disease, the presence of stroke or transient ischemic attack (TIA), medication and surgical treatment, follow-up time, the presence of a recurrence of the disease. The Russian-language AMSTAR and Newcastle-Ottawa Quality Assessment Scales were used to assess the methodological quality of reviews and studies.

RESULTS

The final analysis included 78 articles. Of these, 68 articles describing clinical cases, 5 systematic reviews and 7 retrospective case-control studies. In the process of analyzing the review articles, it was proved that stylohyoid syndrome can lead to the development of vascular complications and a link between ICA dissection and an elongated SP or a decrease in the distance between SP and ICA was shown. However, the reviews had a number of limitations and were of low methodological quality. When considering clinical cases, it was found that without resection of the SP, a recurrence of stroke or TIA occurred in 29% after drug treatment and in 56% after stenting of the ICA. No recurrence was observed in patients after SHO resection in the median follow-up period of 6 months (3-18). Most studies have shown a significant relationship between the length of the styloid process (4 out of 7), the distance between SP and ICA (6 out of 7) and the risk of ICA dissection. One study did not confirm the relationship between the parameters of SP (length, distance to ICA, calcification of the stylohyoid ligament) and dissection of ICA. All the studies turned out to be of low methodological quality.

CONCLUSION

Most studies confirm the connection of the pathology of the stylohyoid complex with the ICA stratification. Given the low methodological level and incomplete consistency of the conclusions, additional high-quality studies are needed, taking into account the identified limitations, in order to prove the connection of stylohyoid syndrome with ICA dissection.