It started off with pain in the eyebrow region on the left, and started off to left sided facial pain, pressure in the temples (all left). Tried physiotherapy, then suspected TMJD and got various scans like CBCT and MRI and assessment by various dentists which ruled out TMJD. Now experience face burning, pain on the left side, eye socket pressure and face pressure and throat (left side) and roof of the mouth (palate pressure) especially when bending the neck to the right or looking down. Also suffer from constant tinnitus (left sided) and intermittent ear pain. The symptoms also exacerbate when I sleep on my right side (right side of the face on the pillow). I also feel pain and tenderness, along with small lump like swellings around the angle of the mandible (below the ear lobe). If I do a forceful swallow (with intensity), I witness face and eye pressure intensify and also ear pain. My TMJ MRI showed a left styloid process of 4.1 CM and right one of 4.5 CM, but a dentist rejected my hypothesis of Eagle’s based on an OPG X-Ray. Now I am left clueless as to what to do. Do my symptoms sound like Eagle’s and can anyone have a look at my OPG X-Ray? I want my life back and have already suffered both mentally and physically because of this.
Welcome to our forum, @excellentjob! Please upload your OPG (panoramic) x-ray, and we can let you know what we see, but our opinions cannot be considered diagnostic because we are not doctors on this forum.
I am very sorry your dentist rejected your suggestion of ES outright rather than taking some time to explore the idea by doing research about ES so he could better help you. Getting your styloids cut back as close to the skull base as possible could help relieve your symptoms, however, many surgeons will only operate on one side at a time so two surgeries may be required. Recovery from this surgery is also slow as it can take some months for nerves to fully heal. We have many members who’ve had very good resolution of symptoms once their styloids were shortened.
I have uploaded my OPG at the end, (edited the original post). Please have a look and let me know
Hi & welcome!
I’m sorry, but I deleted your link to the x-ray as it had your name on it…if you’re able to remove your name & re-post, that would be good, but I wanted to protect your privacy!
I did have a look & it was interesting as you could see there were segments of calcification on the right side, so it may well be that your stylo-hyoid ligament has calcified rather than the styloid growing longer (ES can be caused by either an elongated styloid process, or calcified ligaments, or both).The left side wasn’t as clear though. As @Isaiah_40_31 says, we’re not medically trained, but are experienced at looking at images of styloids- we can’t diagnose you but can say if it’s worth looking into further, & looking at your images & given the measurements you’ve been told from the MRI, plus your symptoms I’d say that it is worth seeing someone with more experience than your dentist.
The pain you describe could be from the Trigeminal nerve, or otherwise the Facial nerve, or both- these nerves are commonly affected by the styloids. It might be worth trying a different nerve pain medication if the Gabapentin doesn’t help- Amitriptyline or Carbamazepine for example?
There are a couple of doctors on our list who we’ve been told about, although we don’t know much, and obviously India is a big country so I have no idea if they’re any good for you, but here’s a link:
Doctor Lists – no discussion - Symptoms and Treatments / Doctor Information - Living with Eagle
There was also a research paper authored by dentists:
Elongated Styloid Process- A Review by Silpiranjan Mishra (1) C. Krithika (2) RamachandranSudarsshan (3), S C Selvamuthukumar (4), Priya Ramani (2), S. Uma Maheswari (1)
Affiliation:- 1Post graduate trainee, 2Reader, 3Senior lecture, 4Professor and HOD, Department of Oral Medicine and Radiology, Thai Moogambigai dental college, Chennai, Tamilnadu, India
But no idea if they do treat ES.
Otherwise we suggest that members try ENTs, Otolaryngologists, Skull base surgeons, Head & Neck cancer surgeons or Head and Neck Neurovascular surgeons as they all operate in the same area as the styloid processes. I have no idea about healthcare in India, how you go about getting referrals, whether you have to pay etc; would it be possible for you to get a CT of your head and neck done, as this is the best scan to diagnose ES, and to be referred to one of these sorts of doctors?
Thanks for your reply. Will try to get a second opinion. Have masked my name and reuploaded 