3D Rendering of my CT

General
1

I know you can't dx, but I'm hoping you can help me identify structures and give an assessment of length of the styloid/stylohyoid. I've searched Google images to try to get a sense of normal length and elongated structures, but still can't tell. Your collective experience may be a better gauge of length than what Google can tell me...

This image was created with 3D Slicer - with the immensely helpful tutorial by SnappleofDiscord. You're looking at my right side (symptomatic side). There's no tilt to the image, it's a straight look at the right side of my head.

Is the structure that descends from my "ear" to the back of my jawbone the styloid/stylohyoid? Is it long?

Thanks in advance for your collective wisdom on the matter!

16-Picture1.jpg (13.8 KB)
2


3

Can't really tell from the pic whether it's the styloid process, or the stylo-hyoid ligament, but it looks like calcification- not that we're experts!

4

I agree, it looks suspicious and pretty long. Could be a combo of the styloid process and calcified stylohyoid ligament.

5

Thanks for the insight.

I generated this image from my existing (NON 3D) CT -- for which no doctor has detected this feature. Do you think a doctor would take this as credible evidence for ES? Or do you think s/he would only accept this if it came from another MD?

I guess what I'm wondering is if I should take this (and other images I've generated) to the doc in Seattle or is it a lost cause?

6

Can't answer that question for sure. I think it would be a good way to start a discussion for further investigation. I'd at least try if I were you. I had a CT without contrast & my styloids were very visible. The only thing that can't be determined w/o contrast is whether there's vascular involvement or not. I did have vascular symptoms on one side so assume something important was being restricted. Those symptoms are gone now that I've had the surgery. I posted my CT pics. If you click the photos link above, there are a number of CT pics. Mine are on pg 3 - the two right hand pics in the top row & the 2 left hand pics in the 2nd row. My ligaments were partially calcified & my styloids were pretty long. Never heard how long though.

7

Could you approach the doctor who tentatively diagnosed you first with these images, as they seem sympathetic? I don't understand why it wasn't visible on the CT ... if all else fails, definitely take it with you and ask the Seattle doc to explain it.

8

Thanks for the suggestion, Jules. I think that's a good start, too. If anything else, I think it's evidence that warrants further investigation. If my original doc agrees, perhaps he can order further tests. Either he can use the tests to definitively dx ES and I don't have to see the Seattle doc or I have a better workup to bring with me when I see the Seattle doc.

Thanks again for your support and suggestions. I'll let you know how it goes...