Styloid Process Elongation and Swallowing-associated Symptoms: A Scoping Review

Abstract This scoping review aimed to systematically map the range of swallowing-associated symptoms reported in adults with styloid process elongation and to characterize how the available literature assessed swallowing. The review followed PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidance and the JBI (Joanna Briggs Institute) methodology for scoping reviews. Searches were conducted in EMBASE, PubMed/MEDLINE, Web of Science, Scopus, LILACS, and LIVIVO, as well as in gray literature sources. Eligibility criteria followed the PCC framework: Population (adults aged 18 years or older), Concept (styloid process elongation), and Context (swallowing-associated symptoms). Observational study designs were considered eligible. After removing duplicates, 1,177 unique records were screened; 15 full-text articles were assessed for eligibility, and 12 studies were included in the qualitative synthesis. Most studies did not directly or objectively assess swallowing function; instead, dysphagia, odynophagia, foreign-body sensation, or related pharyngeal complaints were reported as part of broader clinical symptom profiles, imaging investigations or surgical series. Consequently, the available evidence does not establish a definitive causal or associative relationship between styloid process elongation and swallowing dysfunction. Swallowing-associated symptoms are commonly reported in patients with styloid process elongation, but the current literature is heterogeneous and largely based on non-standardized symptom reporting. Prospective studies using standardized dysphagia instruments and objective swallowing assessments are needed to determine whether, and under which anatomical or clinical conditions, styloid process abnormalities contribute to swallowing dysfunction.