Hello, I tried to stay away from this forum since I thought I would only consider surgery if I had tried everything. After trying prolo with Hauser and upper cervical care, I think it is now time to look back into ES. I now have bilateral neck tightness mainly on the SCM, scalenes and trap and some tightness where the styloid is located (sometimes a bit of pain) . It started on the right side with a not so long 3 cm styloid and my left side is 4 cm. Most of my symptoms are on the right side but it is bilateral and now with Tinnitus… What discouraged me from getting surgery previously is that my case was not clear to be ES per several ENTs in the NJ area, and even Mark delaCure mention that he could not ensure that the surgery can fix me although I did have some ES hallmarks. Nothing else to try now, next step is surgery. Can both styloids be removed during surgery or usually doctors decide to first remove one and later remove the second one? Per my previous CT , nothing was mentioned on calcification, only elongation. Thanks!
There are members who have had both removed at once - I personally can’t imagine how they did it. 
I would try to determine if this is the “root cause”, examine which symptoms are the most severe and proceed from there. (JMHO)
No surgeon is going to guarantee a “fix”, there is not currently enough data to determine. Also, surgeons are cautious folk as far as promises go, for anything.
For me, my quality of life was so degraded by my symptoms that it was worth it - but I did a lot of research personally and with my PCP.
A month post-op and no vertigo- hanging tight.
I’m a former Hauser patient as well. I’m having surgery in a month and I feel much better about it than I did the treatment I was getting from Hauser. I had pretty clear jugular compression on one side. I’ll let you know how it goes. There are several doctors that this board recommends. The good ones are familiar with Eagles and wouldn’t perform the surgery if they didn’t think it would help.
Hi @Emilio,
Welcome back. I’m sorry your symptoms have gotten so much worse. Most of our members who’ve tried prolo spent a lot of money & got no relief. It’s a therapy that sounds good in theory but doesn’t seem to help with ES.
If you’re interested in bilateral ES surgery, Dr. Hackman in North Carolina is the surgeon on our list who is willing to do that. He has helped many of our members & most have had excellent results. As @tokenegret noted, no doctor will/can guarantee a perfect outcome, but based on the number of our members whose quality of life has been improved by ES surgery when done by an experienced ES surgeon, we can confidently say that surgery provides the best long term results.
As far as your worst symptoms being on the shorter side, that’s not uncommon either. It’s not necessarily styloid length that causes symptoms but how twisted, angled, pointed or curved the styloid is that can be more of a factor.
I recommend having a consult w/ Dr. Hackman & getting his opinion as you consider moving forward. His name is on our US Doctors List.
Thanks for the recommendation Actually I live right in the middle between Cognetti and delaCure. I don’t mind doing both styloids at different times. I was leaning towards Cognetti since he seems to have much more experience with members from this group. Hard to tell. i’ve seen delCure in the past and had a good impression but I really would like to see what Cognetti thinks and what his approach would be. Tough choice I think my goal is to at minimum ensure I won’t get worse even knowing that there is a chance the surgery might not help.
Some people in FB group had really good results with Dr Paul Covello (Wilkes-Barre, PA), does bilateral
Cognetti is a good choice & he’s helped many of our members over the years. I say go for it! He does video consults so you wouldn’t need to travel for the initial contact with him.
Oh that explains why Dr DelaCure doesn’t show up in the NYU Langone website. Thanks so much for the update. I’ll definitely aim to have this done by Cognetti then.
Did any of you that got Prolotherapy with Dr Houser see any improvements in your symptoms I’ve gotten a treatments so very little Improvement he did say my styloids were compressing as well as my C1 have you heard the same thing from him
I did not hear that. In my case he actually checked my DMX and confirmed that my styloids were not a problem since the spaces were ok (even though my styloids were a bit long). But I received prolotherapy (4 rounds , 1 per week) and no improvement in my neck pain.
Hi there. I have an appointment with Dr Cognetti tomorrow. I’ve been waiting since February to see him. From what I’ve seen on this site, that doesn’t seem like a very long wait. I have severe jugular compression on the left and mild compression on the right. I’m excited and terrified. I’ll let you know how it goes.
Good luck Karen! Keep us all posted! That’s how I feel about my upcoming appointment at UNC Thursday both excited and terrified! You put it perfectly!
Good luck to you too! I hope you are able to have a productive appointment.
Thank you really appreciate it 
Hi @Emilio - I had bilateral surgery twice - first was intraoral and second was external. External was definitely much easier for me. I ignored comments from others on the forum about intraoral surgery because I was so excited to have found a surgeon willing to remove my styloids. The intraoral surgery was very challenging to recover from and the surgeon only removed the tip of each styloid. External access around the front of my ears was used for revision surgery and it was much easier to recover from. Styloids were removed to skull-base the second time around.
Thanks !!! Were your neck issues resolved after the second surgery? I’ve been snooping around other people’s surgeries and it seems to be common to make the throat pain disappear, but neck symptoms might persist… although my perception could be wrong.
Yes - most of my neck and shoulder issues were resolved. I have arthritis at C4-5, which was not fixed, of course. I really was not expecting neck and shoulder pain to be fixed - I was having vascular symptoms. So having immediate relief of neck and shoulder pain was a totally cool surprise. Vascular symptoms have also resolved.
There have been a few discussions about prolotherapy on the site, so you could use the search function for having a look- on the whole it doesn’t seem to help many members, but Dr Hauser has been good at diagnosing members.
Yes, actually they bought a new machine that does Cone Beam CT with 3D to diagnose better Eagle at caring medical . When I went there last year they didn’t have the machine, so Dr Hauser assessed Eagle using the DMX , he said that my styloids had enough space though . Although, he is requesting me to get a CBCT 3D so can be look deeper. I’ll let you guys know what he says
Emilio,
Since you have been diagnosed w/ ES, & know that surgery is your best choice for recovering from symptoms, it might be worthwhile to stop seeing Dr. Hauser. His fees are high & what you need is a CT scan for official diagnosis not a CBCT. Put your time & $ into getting what you officially need to submit to Dr. Cognetti or whomever you decide on for a consult.
The statement that you have ES but your styloids “have enough space” is a bit ambiguous. The fact you have pain says there isn’t enough space for them at the lengths & angles they have grown. Maybe he means there’s enough space between them at your C-1 vertebra so your IJVs aren’t being compressed or your ICAs aren’t compressed?