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The Association of Ponticulus Posticus & Elongated Styloid Process with Headaches
J Oral Med Pain 2018;43:77-83
Published online September 30, 2018;
© 2018 Korean Academy of Orofacial Pain and Oral Medicine

Shivani Sharma1, Rakesh Nagaraju2, Shweta Sharma3

1Department of Oral Medicine and Radiology, Army Dental Corps, New Delhi, India
2Department of Oral Medicine and Radiology, M. S. Ramaiah Dental College and Hospital, Karnataka, India
3Department of Opthalmology, Government Medical College, Jammu, Jammu & Kashmir, India
Correspondence to: Shivani Sharma
Department of Oral Medicine and Radiology, Army Dental Corps, New Delhi 110011, India
Tel: +91-94-1918-7170
Fax: +91-11-2619-2356
Received February 8, 2018; Revised March 15, 2018; Accepted March 23, 2018.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: The present study was designed to investigate the association of ponticulus posticus (PP) and elongated styloid process (ESP) with headaches.
Methods: Analysis of head and neck cone beam computed tomography samples from the archives of the Department of Oral Radiology was done for the presence of partial or complete PP and ESP length, type, thickness, mediolateral angulation, anterioposterior angulation (horizontal & vertical), lateral or medial curvature. This was followed by personal & telephonic questionnaires to the subjects for the evaluation of the presence of headaches & other associated symptoms.
Results: Among 134 subjects, 62 subjects (46.3%) presented with headache and 72 subjects (53.7%) did not have any headache. On further analysing the total 62 subjects with headache, it was found out that 31 subjects (50.0%) of them had ESP and PP both, 16 subjects (25.8%) had only ESP, and 15 subjects (24.2%) had only PP. A strong association was present between headache and presence of PP & ESP individually and together.
Conclusions: All health care professionals dealing with the head and neck pain disorders should also consider the presence of ESP & PP during diagnosis and treatment.
Keywords : Cone beam computed tomography; Elongated styloid process; Headache; Ponticulus posticus; Surveys and questionnaires

September 2018, 43 (3)