■鹰综合征是由影响颈动脉和颅神经的细长茎突引起的。疼痛,吞咽困难,耳鸣,感觉异常(经典亚型),和神经血管事件(血管亚型)可能由头部运动触发或自发发生。然而,Eagle综合征在神经系统中仍然被低估。我们旨在确定Eagle综合征患者最常见的神经系统和非神经系统临床表现,并评估手术切除后与非手术治疗相比的临床结果。
■我们对患有Eagle综合征的成年人的患者水平数据进行了系统评价,遵循PRISMA准则。我们提取了人口统计数据,出现症状,神经功能缺损,放射学发现,和治疗,包括结果和并发症,来自2000年至2023年间发表的多个索引数据库的研究。研究方案在PROSPERO注册。
■总共,285项研究符合纳入标准,包括497例鹰综合征患者(平均年龄47.3岁;49.8%为女性)。古典鹰(370名患者,74.5%)比血管鹰综合征更常见(117例,23.5%,p<0.0001)。六名患者(1.2%)出现两种变体,四名患者(0.8%)的亚变体未知。血管亚型中男性占优势(男性占70.1%)。扁桃体切除术史在经典(48/153例)中比在血管(2/33例)Eagle综合征中更常见(赔率比5.2,95%CI[1.2-22.4];p=0.028)。相比之下,作为触发因素的颈椎运动在血管性(12/33例)中比在经典(7/153例)Eagle综合征中更为普遍(赔率比7.95,95%CI[2.9-21.7];p=0.0001).血管老鹰综合征中头痛和霍纳综合征更为常见,经典老鹰综合征中吞咽困难和颈部疼痛更为突出(均p<0.01)。手术治疗的患者比药物治疗的患者获得了更好的总体结果:123例药物治疗的患者中有81例(65.9%)经历了改善或完全缓解,而320例手术患者中的313例(97.8%)也是如此(赔率比1.49,95%CI[1.1-2.0];p=0.016)。
■Eagle综合征未被诊断为潜在的严重神经血管并发症,包括缺血性中风.手术治疗比保守治疗效果更好。虽然传统上是耳鼻喉科医师的领域,神经科医师应将此综合征纳入鉴别诊断考虑,因为神经系统表现多样,适合有效治疗.
UNASSIGNED: Eagle syndrome is caused by an elongated styloid process affecting carotid arteries and cranial nerves. Pain, dysphagia, tinnitus, paresthesia (classic subtype), and neurovascular events (vascular subtype) may be triggered by head movements or arise spontaneously. However, Eagle syndrome remains underappreciated in the neurological community. We aimed to determine the most common neurological and non-neurological clinical presentations in patients with Eagle syndrome and to assess the clinical outcome post-surgical resection in comparison to non-surgical therapies.
UNASSIGNED: We conducted a systematic review of patient-level data on adults with Eagle syndrome, following PRISMA guidelines. We extracted data on demographics, presenting symptoms, neurological deficits, radiological findings, and treatments, including outcomes and complications, from studies in multiple indexing databases published between 2000 and 2023. The study protocol is registered with PROSPERO.
UNASSIGNED: In total, 285 studies met inclusion criteria, including 497 patients with Eagle syndrome (mean age 47.3 years; 49.8% female). Classical Eagle (370 patients, 74.5%) was more frequent than vascular Eagle syndrome (117 patients, 23.5%, p < 0.0001). Six patients (1.2%) presented with both variants and the subvariant for four patients (0.8%) was unknown. There was a male preponderance (70.1% male) in the vascular subtype. A history of tonsillectomy was more frequent in classic (48/153 cases) than in vascular (2/33 cases) Eagle syndrome (Odds Ratio 5.2, 95% CI [1.2-22.4]; p = 0.028). By contrast, cervical movements as trigger factors were more prevalent in vascular (12/33 cases) than in classic (7/153 cases) Eagle syndrome (Odds Ratio 7.95, 95% CI [2.9-21.7]; p = 0.0001). Headache and Horner syndrome were more frequent in vascular Eagle syndrome and dysphagia and neck pain more prominent in classic Eagle syndrome (all p < 0.01). Surgically treated patients achieved overall better outcomes than medically treated ones: Eighty-one (65.9%) of 123 medically treated patients experienced improvement or complete resolution, while the same applied to 313 (97.8%) of 320 surgical patients (Odds Ratio 1.49, 95% CI [1.1-2.0]; p = 0.016).
UNASSIGNED: Eagle syndrome is underdiagnosed with potentially serious neurovascular complications, including ischemic stroke. Surgical treatment achieves better outcomes than conservative management. Although traditionally the domain of otorhinolaryngologist, neurologist should include this syndrome in differential diagnostic considerations because of the varied neurological presentations that are amenable to effective treatment.