2 Months Post Surgery

[Rainbow]

Hi everyone. So grateful to find this place and all of you. You have no idea how much you have helped me already. I had an elongated styloid process on the left side only (3.9cm), and I was diagnosed with ES and underwent the transcervical styloidectomy on 06/12/25, so I’m just about two months post surgery.

As far as the pain in the left side of my neck/throat, and like something sharp was stuck down in my throat, that is actually almost entirely gone- about 95%! I can say that I definitely still get a zing or two, and that I’m not 100% yet, but close as far as that symptom!

However, the glossopharyngeal nerve in the back of my throat is very angry. We double checked my imaging to make sure it wasn’t being compressed, and it isn’t. It’s just angry. One of my main symptoms all along was difficulty speaking because of the pain and tension in my throat, and this nerve is definitely still causing that for me, even though the additional pain in the left side of my neck is WAY better. Is this normal? Does the glossopharyngeal nerve just take a lot longer to heal or calm down? I know we probably upset it more with the surgery, so maybe it’s just still recovering and I need to be patient?

I speak and sing for a living, and ES essentially ruined all of this for me. I do the best I can in my job, but I’m still in a lot of pain from that nerve, and it causes tension that causes my voice to fatigue extremely easily. My doctor doesn’t want to put me on any medication yet, but recommended acupuncture and Chinese herbal medicine instead. I go in 08/12 to begin that course of treatment. He did say that if a whole year goes by and it’s still just as bad, then he would give me a neurology referral, but he didn’t think it would get to that. I also wouldn’t want to wait a whole year in pain and struggling just to have it be the same as it is now and have wasted time that I could have used helping it.

Does anyone have any experience with this glossopharyngeal nerve or what might help it heal or calm down? Of course, it is possible that I might just need to be patient too!

[TML]

@Rainbow so happy to hear that most of your pain is gone!! I’m not too certain on how long it can take for nerves to heal post styloidectomy.

Did your surgeon/doctor happen to look at your hyoid bone? The glossopharyngeal nerve runs down by the ICA on both sides right along where the hyoid sits. If you guys haven’t looked into that, I could take a look at your hyoid if you have your imaging on hand? I can help you learn where to look in the imaging.

For me for example, my left greater horn of my hyoid is rubbing against the nerve on my left side. See pictures below.

[Isaiah_40_31]

@Rainbow - I’m sorry you’re struggling with significant symptoms still but am glad some are gone, too.

Vocal issues from ES are usually caused by the vagus nerve not the GPN. The vagus nerve can also affect the throat & neck. I’m more suspicious about it being your vagus nerve that’s causing your current problems than your GPN.

It can take up to a year for nerves to fully recover after they’ve been irritated or damaged, but usually by 6 months (or earlier) the symptoms they are causing will begin noticeably reducing. I had GPN damage from my first ES surgery that caused half my tongue to be paralyzed. It took close to 9 months for the nerve to heal to a point where I could speak more normally again. I know this isn’t what you want to hear, but even though recovery can be slow, it does happen over time.

Getting a prescription for a nerve pain medication such as Gabapentin, Amitriptyline or Carbamazepine could help reduce your pain now, & you may not need to take it long term. Another suggestion is to request a 10 -14 day tapering dose of dexamethasone or prednisone as they are powerful anti inflammatories & might help your body get on top of whatever is causing your current symptoms. Dexamethasone tends to cause fewer side effects than prednisone & works just as well.

Please keep us in the loop as to how your recovery goes forward & what you decide to do if anything to treat the remaining symptoms.

I’ll pray for your voice to get back to normal ASAP.

[Jules]

It is still early days after your surgery, so good that you have an improvement in some of your pain! As @Isaiah_40_31 says, it can take up to a year, we have had members come on after that time to give updates & they’re still seeing improvements- it is frustrating & hard to be that patient though! Did you have this pain before surgery? Interesting that you say your doctor has checked your imaging- was that with an MRI scan?

As @TML says, it might be an idea if you have a look at your imaging to double check the hyoid, & also your other styloid- sometimes the angle & thickness of the styloid can cause symptoms too, it’s not just the length which causes pain!

I hope that you see improvements soon, and can get back to singing

[Rainbow]

Thank you so much for your reassurance, everyone Literally in tears. This has been SUCH a terrible and devastating journey since 10/02/23. This forum has helped me to feel like I’m not alone, as literally no one around me has even heard of ES, so it’s hard for them to understand or relate to what I’m describing.

Yes, I did have this pain before the surgery. It began when the pain in my neck began, so that was why the doctors were pretty confident that resolving the ES issue would resolve this issue. I have had 5 laryngoscopies and 2 stroboscopies, and there is no issue with the vocal cords themselves, thank goodness. However, I have no volume or full strength in my voice, even though the cords are working properly, and it is VERY painful and strained to speak. I did full courses of treatment with voice therapy three different times in the past two years without any change at all. I feel the pain all the time, though, not just when I speak. But speaking does aggravate it more and my voice will just wear out completely after a while. I have been using a voice amplifier a little bit to help, and THAT has helped me communicate at least, so I’ve been grateful. I don’t wear it all the time, but just when I need to project my voice.

I feel reassured that I might just need to be patient, and it sounds like I’m actually right on track as far as stages of healing go. I think you make a great point, though, that it wouldn’t hurt to have someone take another look at my MRIs and CT scan for a second opinion. I’m making an appointment with a neurological institute to have them review it all and see what they think, since they’re the nerve specialists and I’ve already seen 5 ENTs during this process (it wasn’t until ENT #4 that they finally considered ES, btw). I’m wondering if it is some combination of my vagus nerve and my GPN? These are all great questions I can ask in my appointment and advocate for myself to make sure they’re checking EVERYthing.

Question about medication for nerve pain…. if I go on medication, will my nerves become dependent on that medication to not be in pain? Will they be able to NOT be in pain once I stop the medication? Like, could it make it worse or make it so my nerves won’t heal properly or anything? I ask because I tried gabapentin once several months ago before I had the ES surgery, and it made the other nerves in my body act up, and it didn’t have any effect on the actual pain I took it for. I had full body tingling and residual nerve issues that lasted for a few months after taking it. But, I’m thinking maybe I could explain that to my doctor and see what he suggests? I tried Amitriptyline over a year ago as well, and that did nothing except make me gain weight (and I felt slightly happier while taking it- lol). Of course, if ES is the underlying issue, it makes sense that the meds wouldn’t have worked before. And maybe trying a different one that is more targeted to that specific GPN nerve now that the ES has been resolved would help more. It’s worth an ask for sure! Interestingly enough, I did take a 6-day course of methylpredinisone for an ankle injury I had a couple weeks ago, and my throat did feel somewhat better during that time…. Still strained, but it wasn’t in as much PAIN. So, all good things to bring up!

I am definitely curious about getting that second opinion. I mean, speaking is REALLY necessary, and because my symptoms started back on 10/02/23, it’s been a LONG time of not being able to communicate or express myself properly. Very devastating disability to have, as I know most of you can probably understand and relate to.

I’ll let you know what I find out! Thanks everyone!! Love you guys.

[Jules]

I’m glad that you’ve been reassured a bit by the info on here

Different nerve pain meds affect everyone a bit differently, what works for one doesn’t for another…I’ve taken Amitriptyline for a few years without side effects but others haven’t been able to tolerate it. So worth speaking to a Neuro about whether it’s worth trying something else, as far as I’m aware your nerves shouldn’t become dependent nor should it stop nerves healing…

Steroids do help with the inflammation of ES & swelling, they can sometimes be prescribed after surgery for that so probably why they helped with your pain. Obviously you can’t be on them for long though!

Not being able to speak for long must be a terrible ES symptom to have for anyone, sending you a hug & prayers for your voice to return

[Isaiah_40_31]

@Rainbow - We have another member who had very similar vocal symptoms to you - @virenlondon. We haven’t heard from him in a while but he was unable to speak for more than 2-3 minutes at a time w/o debilitating pain prior to his ES surgery, but was gradually being able to increase his vocalizing time afterward. You could send him a PM to ask how he’s doing or perhaps, he will update us on the public forum sometime soon.

PAin on Phonation, physical exertion, and my Story

Hello everyone, First of all, thank you to the people responsible for this forum, as I feel I have been alone for the last 4 years. I wanted to share my story here, as I’ve been dealing with intense throat pain for nearly four years and finally may potentially have the answer. Its a long post, but essentially, I wanted to know if anyone experienced pain on phonation or physical exertion. If so, would love to hear your experience My journey started in 2020 after I sustained a direct blow to my t…

[TML]

@Rainbow do you happen to have your CT imaging? I can take a look at your hyoid if you’d like!

[Rainbow]

Hi there- I do have it and I can get in to my portal to view my images, but I’m still trying to figure out how to even get them from the portal itself…

[TML]

You can probably just take screenshots of the imaging in the portal instead of trying to figure out how to download the imaging from the portal!

[Rainbow]

Okay! I’m in my portal, but there are hundreds of images. Are there ones that would be most helpful to see?

[TML]

@Rainbow axial view is best (the top-down view). Scroll until you see a horseshoe shaped bone in your neck. I have attached some images to help you know what to look for. We aren’t super interested in the front part if the hyoid, mainly the greater horns (the long tips).