Hi all of you, I am now six weeks after surgery of my right styloideus which was more the 4 cm long and which compressed the right jugular vein and had contact with the artery. My main problem was (and still is) an extremely loud pulsatile tinnitus. Last week a had a Angio CT scan which revealed that the surgery was quite successful concerning the removal of the bone. Artery and vein are free, but the vein ist still flat - like it was before. I am full of panic that it will stay lile this. The radiologist said it is very early after surgery and the vein CAN still widen. I will try to send some of the pics and a will be ver happy and thankful if some of the members will have a look onto them. The best for all of you from Inga
1 Like
Hi Inga! Good that you’ve had the surgery, but I do agree with the radiologist in that it is still early days and there could still be some swelling which might affect the re-opening on the vein. Sometimes balloon angioplasty can be done do widen it, or if it still doesn’t open fully again then stents can be put in now that the styloid is out the way, so there are things that can be done if it doesn’t open by itself, but hopefully that won’t be needed!
Have you been icing your neck since surgery, that will help if there’s still some swelling? And is the styloid the other side long as well? If so, some members have found that they need to have both sides removed before all the symptoms improve…
Feel free to post images if you want, and hope that things improve soon 
1 Like
In the axial image (the first one), the IJV on the left of the image- your right side- looks very flattened against the C1 process, is this the side you had surgery on? In the last image it looks like the IJV on the left is pretty open, but barely visible on the right , presuming this is a mirror image then this looks very different to the axial image, so I’m puzzled! hopefully someone better at interpreting these can comment!
2 Likes
Thank you for interpreting the pics Yes - surgery was on the right side and the Styloid had pressed the vein obviously
1 Like
@inga - It looks like you have/had bilateral IJV compression, so I fully agree with what @Jules said about you possibly needing a second surgery to get the best results.
The left IJV, it definitely looks better than the right one at this point. The right side is very flat. It looks like the left TP of C1 has been removed.
1 Like
Thank you very much for the deeper look into the the pics.
It is to be seen like a mirror. What you circled left is the right side and vice versa.
So - I had surgery on my right side. My left side ( what you circled as right side ) was untouched so far. My right side is the problem. Even after surgery the vein is near to the TP and I still have the pulsations 24/7.
Dr Martini and all the other German doctors don’t do the shaving.
I feel very helpless now. Though the bone was removed the problems still exist - even stronger.
1 Like
Thank you for looking to the photos. You are right. The left side on the first picture is my right side - the operated one. The radiologist also noticed that the vein is near to the TP. but he remarked that it is not impressed by it. But nevertheless it has not widened. None of the different doctors can tell me why I hear my pulse every second all day long.
I hope giving it some more time will improve the situation.
1 Like
I hope for you too that things will settle down, but the IJV does look very flattened, possibly the C1 process, and maybe some soft tissues- sometimes the muscles can be made out in the images, but I can’t see them here…
I guess it’s worth waiting a while to see what resolves, and then consider your next steps- that could be try removing the other side & see if that helps, or look into getting a C1 shave, but presumably that might mean travelling abroad, & that’s just nor possible for everyone, or otherwise look into getting balloon angioplasty of your IJV & stenting if needed. Unfortunately occasionally that is needed. Praying that this improves for you 
1 Like
Thank you for the correction, @Inga. I’ve corrected the image & my post. I was very tired last night when I annotated your picture.
It looks to me like the transverse process of C1 is compressing your right IJV in spite of what the radiologist said. It looks like the styloid may also not have been cut back quite far enough to clear your IJV as it’s still visible above the IJV. All that said, there may be enough space for your IJV to open up a bit over time. If you’re still feeling so poorly in another couple of months, then you may need to consider seeing someone for a revision surgery to have C1 shaved. It’s curious that your left C1 transverse process looks so small compared to the right. That leaves a lot more space for the left IJV.
Thank you very much, Jules! Are there members with experience concerning stenting? Also this is usually not done here in Germany.
At the moment I feel extremely bad. But thank you again.
1 Like
@Inga - You would not want to get a stent w/ C1 so close to you IJV as it could cause worse problems.
Hi @Inga, I had a left side styloidectomy and c1 shave done 10 weeks ago and I’m still suffering from Pulsatile tinnitus. I had a arteriogram and venogram done 2 weeks ago as the neurosurgeon thought my IJV was still compressed by what he could see on the CT scan after the surgery and that he would need to put in a stent. However, once he was doing the arteriogram and venogram he could see that there was no stenosis on either side and so didn’t put in a stent. I’m still having the PT, but I do have some good days where it is barely noticeable - not very many, but that gives me hope. I also started using the Lenire device for my tinnitus and hyperacusis. I’m only one week into the treatment, but the audiologist is very confident that this is going to give me some relief. Sending prayers your way!
2 Likes
Thank you Isaiah for looking again at the photos. I can only hope the the vein is free. A shaving is never done here in Germany and even in Europe it is seldomly done. Only in Türkey i think. But it is extremely expensive and insurance to not cover it here. So I have to wait. The Angio CT at least shows the the blood is at least passing the vein. So I must wait, which is not easy. But thank you again.
2 Likes
Thank you Texas Eagle Suffer, that gives me some hope. Is the pulsatile tinnitus your only symptom? Bad enough! Do you have a further tinnitus? Did your neurosurgeon tell anything about the correlation between PT and eagle? For me it is still a mystery.
I hope that your sounds will disappear soon. Have a good night (it’s already midnight in Germany)
2 Likes
PT was my primary symptom and yes it was/is bad enough for me to have the surgery and even go forward with the arteriogram and venogram. I have tinnitus, but it has gotten about 5x louder since the PT started at the beginning of the year. I also have hyperacusis (sound sensitivity) which has gotten pretty bad to the point where I have to wear an earplug. I am hoping that between the healing from the surgery and using the Lenire device I will get more relief in the next several months. It is a much longer process than I was hoping for.
3 Likes
I also have tinnitus, a screaming sound, which also has become louder since March. I use hearing aids, but they don not help much. I hope and pray for you, too.
3 Likes
I’m a newbie here, but I feel for you and Texas with that awful pulsatile tinnitus. I get it when I’m leaking Cerebrospinal Fluid, though thankfully only a mild version.
Can I ask – if you know – why the surgeons there don’t shave C1? I saw Dr. Osborne here in Los Angeles. He wasn’t particularly interested in the compression issues, but he said he doesn’t believe in shaving C1 because in order to remove the bone, he’s also removing muscle and tissue that connects to it, which further unstabilizes the bone. I don’t know enough about any of this to know if I agree with him or not. Clearly some doctors do not agree with him since they do shave the C1! Just curious if you’ve heard the European reasoning behind not shaving C1? Thanks, and I hope you’re feeling ok today. – t.
2 Likes
Thanks for that encouragement! I hope things continue to improve for you & good you didn’t need the stent! I’ve been thinking of you & was going to message to see if there was any improvement, sounds like a teeny bit?
2 Likes
It’s a question we’ve debated often on here! Quite a few doctors believe as Dr Osborne does that it might make the neck more unstable, & as many members have CCI that’s not good! But other doctors believe a small shave to make enough space for the C1 won’t cause instability and will do more good than harm. @TML made a good point that maybe the instability is caused by weak muscles, & that the muscles have weakened because of awkward head & neck position, caused by the styloids compressing blood vessels, the body trying to make extra space for them, an interesting thought! And there are some who think that the styloids elongate to make the neck more stable and that even them being removed can cause instability, so it’s all quite a conundrum! There doesn’t seem to be any clear answers with members who’ve had the surgery, it’s helped lots, but there are some who feel it hasn’t…
3 Likes