To evaluate the outcome of dissecting the styloid process via an extraoral approach combined with antidepressants for treating Eagle's syndrome. Twenty-two patients with Eagle's syndrome underwent resection of the elongated styloid processes under general anaesthesia via an extraoral approach. All patients completed a self-rating depression scale preoperatively, and a score over 49 was defined as depression. The patients with depression were treated with fluoxetine 20 mg/day for 3 weeks postoperatively. In all patients, the abnormal length of the styloid process was resected. No surgical complications were observed. Eighteen (81.8%) patients had depression, and all 22 patients were followed for 7 to 26 months: 19 were symptom-free (86.4%), two patients with mild or moderate depression obtained almost complete remission of their symptoms, and one patient with severe depression obtained partial remission. No complications of medication occurred in any patient with depression, and all patients had a satisfactory cosmetic result and no paraesthesia. Dissection of the styloid process via an extraoral approach is simple and reliable; dissection of the styloid process combined with antidepressants (fluoxetine) is preferred for treating Eagle's syndrome.