IN 1937 I1 presented the first case of clinical symptoms due to an elongated styloid process observed in the clinic of the division of otolaryngology of the department of surgery of Duke University School of Medicine. At that time I reported 2 cases in which there had been surgical shortening of the elongated process and 2 cases in which there had not been an operation of this type. In 1940 a series of 43 private cases with a diagnosis of elongated styloid process was reported from our clinic by Fritz,2 which included the 4 previously mentioned cases. From 1940 to December 1946 we have observed 211 additional cases on the private service at Duke Hospital, making a total of 254 cases, an average of 35 each year on the private service alone. There has been a total of 44 operations on these private patients, for shortening of the styloid processes.