Elongated Styloid Process syndrome is caused by an over-elongated styloid process and ossification of the styloid ligament, and manifests with various symptoms such as sore throat, odynophagia, and earache. We present the case of a patient with an elongated styloid process who presented with an intractable sore throat. A 43-year-old woman had been treated conservatively at various hospitals for a sore throat, but her symptoms failed to improve, and she was referred to the Department of Otorhinolaryngology of our hospital for surgical treatment.

At the time of the visit, there was no salivary retention in the pharynx, but examination revealed tenderness around the right tonsil and hyoid bone. 3D-CT showed ossification of the bilateral stylohyoid ligaments, which was determined as being the cause of the symptoms. The patient underwent surgical treatment via the transcervical approach. Thereafter, the sore throat gradually improved, and the pain resolved by one year after the surgery. Elongated styloid process syndrome should be borne in mind in the differential diagnosis of intractable sore throat. Surgical treatment should be considered if the symptoms of elongated styloid process syndrome do not improve with conservative treatment.