| Summary: | AbstractAn elongated styloid process (SP) may cause a painful condition known well as Eagle syndrome. The elongated SP rarely causes internal carotid artery (ICA) dissection, and this event may not be recognized by otolaryngologists. We report the case of a 52-year-old man presenting with a 3-day history of sudden onset otalgia and gradually worsening ptosis on the left eye. He was initially suspected of having facial palsy because no other abnormality was noted on physical examination. Magnetic resonance imaging revealed dissection of the left ICA and excluded cerebrovascular diseases. Computed tomography revealed an elongated left SP in close proximity to the left ICA. Therefore, the patient was diagnosed with ICA dissection due to the left elongated SP causing radiating pain and ptosis, which is also a symptom of Horner syndrome. Otolaryngologists should be aware that an elongated SP can cause ICA dissection, and the symptoms can mimic facial palsy.
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