8 days post-op: intraoral bilateral styloidectomy

General Eagle Syndrome Stories
1

Hi everyone. I’m a 35yo female from VA diagnosed with bilateral Eagle Syndrome in spring of 2024. Last Wednesday I underwent intraoral bilateral styloidectomy surgery. I had my tonsils removed back in high school, so I didn’t need those removed also. My left styloid was poking into my throat tissue and causing a lot of discomfort. The right was also poking enough to cause a foreign body feeling.

Recovery so far has been really rough. I don’t handle anesthesia well, so the first two days post-op were lots of anxiety, pain, head fog, nausea, dizziness, and general malaise. The pain was very intense. I usually don’t do well with narcotics either so I avoided the oxycodone for the first two days. But the pain became too much day 3 and I caved and took the pain medication.

Every day since surgery I’ve had jaw pain, really intense deep inner ear pain, limited mouth movement, limited tongue movement, pain when swallowing, headaches, brain fog, sharp stinging throat pain, and uncomfortable feeling the sutures at the back of my tongue.

The morning of recovery day 7, I woke up with more pain than the previous day and had what looked like a liver clot over the left side healing section. I contacted my doctor and he said it looked like the sutures had pulled through and to continue my daily mouth washes, do a water rinse after every meal, and to monitor for any additional bleeding. I haven’t had any bleeding since, but the pain definitely set me back a few extra recovery days.

I have constant fears that healing isn’t going correctly. I’m already really tired of being in pain, not being able to eat healthier solid foods, having constant headaches and not being able to take additional medication to relieve them, lack of sleep, etc.

I have pictures once I figure out how to post them.

2

@Mpickham - Our system doesn’t let new members include images in their first post on the forum. It’s a precaution against spam. Your account has now been upgraded so you can post images going forward. Please try again. If you still get the error message, please let us know, & we’ll contact ModSupport for help.

Intraoral surgery for ES is initially much more painful & more difficult to heal from than transervical. Since you had bilateral intraoral surgery, you’ve gotten the “double whammy” of pain & post op inflammation in your throat & neck. The symptoms your having are mostly from angry nerves though headaches & brain fog can be symptoms of vascular compression. Do you know if your internal jugular veins were compressed by your styloids &/or C1? If so, the brain fog/headaches may be related to further post op swelling.

These are typical post op nerve symptoms especially after intraoral surgery & should gradually subside over the next month or two. Symptoms caused by irritated nerves can take even up to a year to gradually disappear but often go away much more quickly than that.

Sucking on ice chips, popsicles, sipping ice water, or anything cold can help reduce throat swelling. Having a sore jaw post op is even typical for those who have the transcervical approach & it can take several weeks to subside. Requesting an Rx for a steroid such as dexamethasone or prednisone to take can be very helpful w/ reducing swelling which helps w/ symptoms reduction, too. Some doctors include it w/ the pain meds Rx for post op while others don’t. I think it should be part of the post op medicine protocol for all patients (except those who can’t take steroids) because it is so helpful in the early days after surgery.

I’m glad your throat is ok after the situation w/ the sutures & am sorry for the recovery set back. It’s important to take it easy for the first month after surgery if possible. Rest when you’re tired & ease back into your regular activities. Too much too soon can also cause regression into pain.

Please keep us posted as to how you’re doing. I look forward to seeing your pictures when you post them.

3

That sounds really rough :hugs: As @Isaiah_40_31 says intra-oral is a more painful surgery, a bit more complicated to heal from because of the risk of infection, & having bilateral will take longer to heal too…
One of our members, @michelle posted her story, it might be helpful, here’s a link:
Intraoral surgery: my story, preparation & recovery tips - Symptoms and Treatments - Living with Eagle
Even with external surgery opening your mouth wide & chewing can be difficult afterwards, I couldn’t eat solid food for over a week, I guess any fruity ones would really sting, but maybe you could have banana & yoghurt smoothies, or protein shakes ?
I hope that you start to see improvements soon, sending you a hug :hugs: :folded_hands: :bouquet:

1 Like
4

You poor thing!! It sounds like you’ve had a rough time since surgery. Hopefully, you’re feeling better by the time you see this post.

I’m a doctor…and had a tonsillectomy in 2022, which was awful compared to my easy transcervical styloidectomy 7 weeks ago, so here is some advice:

  • Remind yourself that the darned surgery’s behind you!

  • Make sure you see your surgeon soon

  • Elevate the head of your bed

  • Acetaminophen does wonders. Just make sure you are not exceeding 2 to 3 grams per day.

  • You can try measuring out the dose ( typically 625mg to a gram in adults) of the children’s suspension. Keep the bottle in the fridge and just sip it slowly from the cup from the package, because it will also work locally.

  • Ask if/when you can take ibuprofen or naproxen

  • If the pain is severe, don’t hesitate to use the prescription pain medicine. You’ll heal faster with good pain control.

  • Make sure you don’t get constipated. Milk of magnesia, Senokot-S, Miralax (or even a combination) will help you.

  • Cool liquid diet until better, as posted by others

  • Multivitamin

  • Hopefully, you will feel much better soon!

2 Likes
5

Hey there how are you doing now? I’m 3 weeks post op and having a hard time with the nerve pain and weakness in my shoulder, arm and hand. Also having intense anxiety still with some morning nausea. The extreme pain from week 1 had gone away.

6

It’s a slow process, recovering from ES surgery, so patience is needed…the accessory nerve can get irritated with surgery, but this does usually improve with time…it’s a bit early yet but nerve pain meds might help, & PT to strengthen the muscles. I hope it improves quickly for you, sending you a hug :hugs: :folded_hands:

2 Likes
7

Thank you! My doc reduced my right from 4.5 to 3cm- I suspect it’s not enough but I guess too early to tell. Maybe the 4-6 week window will show. I wonder at what point people decide it didn’t work and need revision. Things have certainly improved but I still worry… I’m doing PT stuff at home as I know a lot for it, but am hesitant if the nerve is still healing and burning like it is.

2 Likes
8

Yes, it’s best to be very careful doing any exercises for now, it’s still a bit early in the healing process yet… I think as nerves take up to a year to heal, I wouldn’t make any decisions about a revision surgery yet, & if your other side is causing symptoms too it would be worth having that side removed first (with a surgeon who’ll take more off next time), as sometimes there can be cross-over symptoms…If you do decide to get the other side done, 3-6 months is a good time frame after this surgery, not before then :hugs:

1 Like
9

Thank you, this has been a big question Ive rolled around in my head, whether to go for the left first and wait it out on the right, or beg him to just take the right out first and foremost. I’m definitely getting headaches, jaw and ear pain, pulsatile tinnitus, and heart palpitations from the left. I recall a lot of resolution to like 80% better after I had the left side fractured last year, which was 3 months after the right was done. I had been let go and unemployed for 4 months when I got these procedures. I got thr right done in May, then the left in Sept & I started working again a month after the left was done.

2 Likes
10

The reason breaking the styloids is dangerous is because they’re very close to the internal jugular vein & internal/external carotid arteries. The sharp broken edges could put those vessels at risk for injury or rupture.

@alibabac - Your headache & pulsatile tinnitus could be symptoms of internal jugular vein compression. This would also make sense in light of your increased anxiety, & heart palpitations being caused by your vagus nerve as the vagus nerve & jugular vein are very close to each other as they run between the styloid & C1 vertebra so if the IJV is squashed so is the vagus nerve. It would be worthwhile getting a CTV to look for IJV compression prior to having another surgery as it will require a more technical surgery for your IJV to be decompressed. If that’s necessary, you’ll possibly need to see one of the 4 surgeons on our doctors list who specifically do that type of surgery.

1 Like
11

I had gotten a CTV and my vascular and ENT doctor confirmed no vascular is involved. There’s mild compression of the jugular when laying on my back from the C1 but not from the styloid. But I would have to agree that the pulsatile tinnitus says differently. I feel or hear it randomly, sometimes laying on that side. I don’t recall having this until the fracture was done on that side. Prior it was regular tinnitus and wooshing. So maybe there’s still a bit of looseness to the styloid in there, and it’s bumping into vascular causing the thudding. The headache was a back pooling of blood under the skull base from the styloid for sure. That was seen on the venogram previously. My headaches were absolutely terrible. I don’t really have them now as much.

1 Like
12

I’m glad your surgery has helped reduced the vascular symptoms. I hope they never recur!

1 Like