Extreme Unilateral Styloid Process Elongation With Tortuous Morphology, Marked Anteromedial Angulation, and an Ipsilateral Pterygoalar Bar

The styloid process (SP), a component of the stylohyoid complex (SHC), demonstrates considerable anatomic variability in length, angulation, ossification, and morphology. Although elongation has traditionally been regarded as the principal feature of Eagle syndrome, growing evidence suggests that 3-dimensional orientation may be equally important. We report a dry skull specimen demonstrating a markedly elongated unilateral SP with a tortuous shaft and pronounced anteromedial angulation. The osseous contour was continuous throughout its course, without evidence of fracture, segmentation, or pseudoarticulation. The distal tip projected medially toward the expected parapharyngeal space. An ipsilateral complete pterygoalar bar was also identified, creating a rare combination of skull base variants. This case highlights the importance of evaluating SP morphology beyond simple length measurements and underscores the potential influence of angulation and curvature on adjacent neurovascular and pharyngeal structures. Recognition of such variants is relevant for anatomists, radiologists, otolaryngologists, oral and maxillofacial surgeons, and skull base surgeons.