Anatomy Question

General
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So, I’m trying to make sense of my pain and post-surgery… oddities.

I found this description of one of the muscles that was “divided”:

The stylohyoid muscle extends between the temporal and hyoid bones. By acting on the hyoid, it facilitates tongue retraction, swallowing (deglutition) and keeps the airway open during inspiration.

I’m thinking that perhaps the “division” of this muscle may account for me feeling like I’m almost swallowing my tongue now when sleeping on my back? (I know it’s impossible to swallow your tongue) it just feels like it’s very - in the way. Trying to move my tongue hurts - like when I got some peanut butter stuck between my cheek and teeth. Had to use my finger. :slight_smile:

This is from my surgical notes:
“ we divided and excised segments of the styloglossus muscle and stylohyoid muscle.”

The styloglossus muscle also moves the tongue. So I’m thinking the pain on moving my tongue, and the fact that it feels like a great big slug sitting in my mouth - that’s directly from cutting these muscles. ?

Then there is the digastric muscle:

“The digastric muscle was then removed off its attachment to the mastoid bone with electrocautery. We retracted this with a mosquito clamp and divided at the tendinous segment and removed this in entirety with absolute hemostasis.“

According to kenhub, I’m thinking this is why everything under my chin is in such pain.

Thoughts?

I’m also wondering what this implies:
“
We identified a very generous brachial cutaneous nerve and this was mobilized, dissected free with minimal retraction.”

Was the mobilization (which I understand to mean they moved it out of the way but didn’t cut it or anything) possibly the reason for the numbness along my jawline, and numbness and pain in my earlobe?
Might the cranial nerves also be irritated after this?
I’m guessing “generous” means larger than usual, so was it being squashed along with my IJV?

Yes, these are better questions for my surgeon or GP but it’s difficult to get answers from them.

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I know much of this is covered in @Jules posting of symptoms, I’m just curious regarding the addition of these symptoms post-surgery.

I’m quite hoarse and talking for very long hurts, but it makes sense post surgery as well, I guess.

The tinnitus is completely gone, and I’ve only had 1 vertigo attack, and this is at 3 weeks post op so overall I’m pleased.

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@tokenegret tinnitus as in whooshing (pulsating) tinnitus or constant beeping/white noise?

As for the numbness… most likely your platysma muscle was cut (external surgery, right?). The muscles, skin etc are innervated by a network of small nerves, which are obviously cut in order to reach the deeper layers of the body. These nerves regenerate rather quickly, as long as the main nerve is nearby.

My platysma took about 16 months to recover to the level I don’t need to think of it. Though I get frequent numbness likely due to the other reasons, like the remaining stub possibly pressing on the cranial nerves.

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My glossopharyngeal nerve was in the way during my first ES surgery, & I ended up w/ half my tongue being paralyzed for abt 6-9 mos post op. Since then, I do have the same problem you’re having when you sleep on your back. My tongue seems to slide back & block my throat. Sometimes I wake up suddenly feeling oxygen deprived because my tongue has blocked my airway. I’ve discovered this happens only when my neck is in flexion i.e. chin toward chest as I sleep. When I arrange my pillow (it’s a down pillow) so my neck is in extension i.e. head tilted slightly back, I have no problem w/ my tongue slipping back into my throat.

As far as your tongue pain & the other pains you’ve described, I think your self-diagnosis sounds pretty accurate. I suspect that as the areas where muscles were divided or removed heal, the pain, numbness, etc. will go away. In answer to your nerve question YES! Some of the cranial nerves can’t escape being touched or slightly moved to protect them during this surgery so they can cause some post op symptoms that you didn’t have prior to surgery.

Here’s a video link which was posted by @Red_Pill in 2013 which you might find interesting.

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Numbness etc along the jaw & ear lobe is really common after surgery- I would presume from either the facial nerve or the trigeminal nerves being moved out the way. Unfortunately when muscles are cut during surgery, it does make healing longer, but it’s not always possible to avoid…
You’re doing really well trying to get to the bottom of your remaining & post-surgery symptoms! I hope that you keep healing… :hugs: :pray:

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Talking post surgery can be painful, we’ve had quite a few members comment on that, especially people who talk alot for work, so it is normal & should improve with time :hugs:

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I had JUST figured out the neck angle tie… it seems if my head is not tilted back, when I breathe out I make so much noise even my heard-of-hearing dog can hear it. He steps up to the bed and starts poking me with his nose and whining.

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Sounds like we have similar problems. The noise is likely being caused by your throat being blocked by your tongue. When the air tries to escape as you exhale it has only a very small space from which to exit. That would vibrate throat tissues which cause the sounds that alarm your sweet :service_dog: companion.

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My tinnitus was a constant ringing, but in the last month before surgery it would also thump. Interestingly, if my eyes were closed I would also see circles of white thumping, too, if I had exerted myself. Both are gone now.

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Constant ringing is gone??? I’m so glad, happy for you, and jealous at the same time!!!

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I’m in @vdm’s camp!! :weary: