Dr. Samji said something in my consultation that I wanted to ask you all about. He said he wasn’t sure that calcified ligaments cause too much of a problem because the calcification is often sort of chalky or powdery rather than actual hard bone. I’ve seen people post pictures, however, that show calcified ligaments that look quite like bones. If the calcification is softer, would it still cause problems?
That is a curious comment by Dr. Samji. I suppose he must have encountered that scenario when doing surgery, but I’d question that ligaments that look like bones in a CT scan would be “powdery”. That may also explain why he won’t help people who have calcified ligaments w/o elongated styloids.
When I had my styloids removed, he told me he routinely took out both the styloids & stylohyoid ligaments to remove all opportunity for further calcification. I know he’s changed some of his protocols since I had surgery w/ him so I don’t know if he still does that.
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He does still remove the stylohyoid ligaments, calcified or not. He’s removed hundreds of them, so I suppose I trust what he’s saying. It’s just different than what I had heard previously.
I had my left styloid removed 3 weeks ago. While healing takes time, I definitely still have symptoms. On my right, I have some calcification on the ligament in addition to an elongated styloid. When I toy around with my 3d ct, it looks like the calcified bit rubs right on my pharynx, well the outside of it. If the calcification is really just chalky residue, it may mean nothing. However, if it is hardened, that could very well be what is causing my symptoms. As I consider whether I’ll try removing the other side, I’ve been thinking more about what he said.
That does sound strange! But at least he takes the ligaments out while removing the styloids…It’s still early days for you yet, so still time for symptoms improve. I would think that it’s worth getting the other side done if it does cause you symptoms so you can be as pain free as possible…praying for more healing 
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Two comments - It’s very common in bilateral cases for symptoms from the not-yet-removed side to ramp up after the first side is removed. Sometimes these symptoms can “crossover” & cause pain on the operated side giving the impression surgery didn’t really help. I had that problem.
As @Jules noted, you’re very early in recovery still. Things will be different at 2, 4, & 6+ mos post op than they are today. I had elongated styloids w/ some ligament calcification as well. It wasn’t until both styloids & ligaments were gone that my ES symptoms resolved by abt 98%.
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Hmmm, I had my left ligament removed (not my styloid process) and it was definitely causing issues as it was so calcified it had become like a bone. You can see the photo of it here:
Post Op Ligament
Note that I included ligaments in my response. It’s hard to know when styloids elongate whether it’s actually the ligament that has calcified up to the styloid making the styloid look long or if the styloid itself has elongated since styloid elongation usually follows the line of the s-h ligament. That’s why the symptoms caused by calcified ligaments only are identical to those caused by elongated styloids. You mentioned that your right ligament is almost completely calcified. That means it’s calcified from hyoid bone to styloid process which means your s-h ligament is badly tethered by the calcification which is keeping your s-h ligament from being able to move as it needs to for many functions such as swallowing, breathing, coughing, sneezing, talking, etc.
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I’ve always been confused about removing the s-h ligament and bones. If the s-h ligament is used in many functions, wouldn’t removing it cause more issues down the line? How did talking/swallowing feel for those who had it removed? I have ossified s-h ligaments, I’m not sure what the difference is with calcified.
I’ve had one styloid and it’s stylohyoid ligament removed. It didn’t affect my swallowing or talking. I think there are other muscles and ligaments that make up for whatever it was doing.
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When the structure is calcified, it’s already barely doing its job
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@syrup - ossified = calcified - just two different words w/ the same meaning. I had the same experience as @Ladybug. My styloids & s-h ligaments were removed. I periodically have some trouble w/ choking when I take a sip of water, but I had that problem before ES surgery so it may be unrelated. Otherwise, I don’t even know the ligaments are gone.
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Good info ,If I had left side removed and my right side is calcified do that need to come out.?
That’s a question which is asked alot- I didn’t notice any difference with swallowing etc after my surgeries, so the ligaments attached to the styloid clearly don’t play a major role!
@Michael123 - It’s best to make that decision after you’ve healed for a few months from your first surgery. For many of us (me included), the symptoms from the remaining styloid got much worse after the first styloid was removed so there was no question about whether to take out the second one. For some, however, once the worst side is dealt with, the remaining side causes no problem. In those cases, we recommend leaving it alone i.e. don’t have unnecessary surgery just because you know the elongated styloid is there. That saves money, recovery time, & eliminating the risk of nerve damage during surgery.