A thin transparent line is usually imagined between towards the SP shadows and the tympanic bone in this area on the PRs. This transparent line corresponds to the cleft between the SP and the temporal bone��s tympanic plate.8,16 The tip of the SP is its bony end including calcified parts of the ligament. All the PRs were viewed in subdued ambient light using transmitted light from a standard viewbox. The lengths of the SPE variants were measured using a true-toscale radiometric ruler (magnification factor: 1.4). The radiographs were investigated and the measurements were performed by the same author (Y.S). To check the intraobserver variations, measurements were repeated after one month on a subset of 300 PRs. Deviations of the mean length of the SP between first and second measurements were <2%.

SPE can be assumed if either the SP or the adjacent stylohyoid ligament ossification shows an overall length in excess of 30 mm4,6,8,10 (Figure 1). Figure 1 Panoramic radiograph showing in a patient with bilateral elongated styloid styloid processes (arrows). The observed results were analyzed with SPSS 15.0 (Statistical package for social science Inc., Chicago, Illinois, USA). t-test and Chi-Square tests were used for statistical analysis. P values less than 0.05 were accepted as statistically significant. RESULTS Seven hundred and fifty patients with dental problems were enrolled in the present study. The PRs of 52 patients who have questionable SPs were excluded. Therefore, on 698 (285 male; 413 female) of the 750 PRs, the length of the SP could be measured at least on one side.

The mean age of these 698 (93.1%) patients was 34.9��14.1 years. Fifty four (7.7%) subjects demonstrated SPE at least one side (Table 1). The mean age was significantly higher in the patients with SPE than the patients without SPE (p=0.04). The mean age of these 54 (40 male; 14 female) subjects was 38.7��13.1 years. The mean ages for male and female patients with SPE were 39.1��14.0 and 37.5��10.7 years, respectively (Table 2). No significant difference in mean age between the two samples was detected (p=0.7). The mean SP length was not significantly different between the male (38.1��6.2) and the female (36.6��6.0) patients with SPE (p= 0.4). Table 1 SPE prevalence in relation to age and gender Table 2 Age distribution of elongated SP according to gender The SPE incidences of the patients in relation to the six age groups are summarized in Figure 2.

There were statistical differences between 10�C19, 20�C29 age subgroups and 30�C39, 50�C59 age subgroups in terms of the SPE prevalence, but not other subgroups (p= 0.036, 0.038, 0.022, AV-951 0.035, respectively). Figure 2 Styloid process elongation prevalences in relation to age subgroups in patients with dental problems. DISCUSSION The elongation of the SP and structural changes in stylohyoid ligament with its clinical symptoms and signs were first described by Eagle.