I ran across a scientific article from Senegal that can be accessed in full without a subscription to the journal:
These ENTs are reporting on 15 cases of ES, in general recommending external surgical approach over internal. They are talking about hospitalizations post-surgery, which I doubt most of us have had, but there is other interesting information here that compares pain level, rate of recovery, and other factors. I also liked the documentation that only 10 of 15 patients had pain on palpation of the tonsil area during exam and that they believe ES is under diagnosed.
I am sharing because I thought some people might want to print for their doctors or perhaps some who live in regions of the world near these investigators would be interested in where to find care.
For those interested in more technical information… A new paper just came out that is geared towards forensic pathology. I found this to be a fascinating read because it talks about the embryologic origins of the hyoid and styloid and gives more information about hyoid syndromes than I have seen in other places https://www.nature.com/articles/s41598-019-52476-z
Hi Everyone,
Here is some cool ES science for the waning hours of 2019. There is a really interesting new published paper that is relevant to those of us with high intracranial pressure, whooshing in ears, visual changes, and headaches from their ES. https://www.sciencedirect.com/science/article/pii/S0967586819316479
You will only be able to see the abstract of the manuscript at this link, but what they did was create a 3D model from the CT of a patient with ES who had high intracranial pressure and pseudotumor cerebri caused by styloids that were compressing the internal jugular. They hooked the 3D model up to a fancy device that pumped liquid, to simulate blood flow through the internal jugular, and then they measured pressure changes when they “turned the head” of the model. They were able to show greatly elevated intracranial pressure with positioning changes. Then they “resected” the styloid on the model by degrees, each time turning the head to check pressure changes. Were able to demonstrate elimination of the abnormal pressure change from styloid removal, with increasingly positive result as more of the bone was taken out.
Here is a brief description of pseudotumor cerebri https://www.mayoclinic.org/diseases-conditions/pseudotumor-cerebri/symptoms-causes/syc-20354031
Sorry I hit reply too quickly. In addition to change in flow through jugular itself, they demonstrated improvement in pressure in their simulated larger cerebrovascular system, which is the part that relates directly to symptoms of high intracranial pressure.
