I’ve got bilateral calcified stylohyoid ligaments. The length of my styloids are normal and they are NOT compressing the jugulars. What symptoms can these cause? Do they need to come out? They both appear to be coming into contact with my external carotid arteries.
Nakaji noted “calcified thin styloid” on his pre-consult yet my case wasn’t accepted so I wasn’t able to ask questions. I assume he wouldn’t note that unless it meant something.
Any suggestions would be appreciated.
Calcified stylohyoid ligaments can cause all the same symptoms as actual elongated styloids. It just depends on where the calcification of the ligaments are in your neck as to what symptoms they cause. Normal length styloids w/ the addition of ligament calcification which is not attached to the styloids seems less common but we’ve had a number of members with that situation. It seems doctors are less interested in operating on ligament calcification alone which is odd especially when patients are symptomatic from it.
When I was diagnosed w/ ES, the diagnosing doctor told me what I had was calcified stylohyoid ligaments. Never once did he call mine elongated styloid processes even though, by all appearances, my styloids were elongated.
It seems that what we think of as elongated styloids is, to at least some doctors, actually calcification of the stylohyoid ligaments which start at the tip of the styloids & move toward the hyoid bone, vs actual elongation of the styloids. Does that make any sense?
From what we know about your imaging, it does seem odd that Dr. Nakaji would comment on a “calcified, thin styloid”. You would be well within your rights to ask him for clarification about that. Be your own best self advocate & press for answers to your unanswered questions even if he won’t see you.
If calcified stylo-hyoid ligaments are coming into contact with ECAs, then I would definitely want them out myself.
Hi Luckee7,
I am very new to this Eagle Syndrome world and by no means an expert but I can say you should continue your journey and find a medical professional interested in your case.
Please keep us us posted 
Audrey
Thank you, Audrey.
Have you consulted with Constantino? I agree you still need more clarification from Nakaji.
I am happy to tell you all that Nakaji just offered surgery. I’m a little confused because he spoke about the styloid. As far as I know, the styloid is not involved… Just the transverse process. He did not mention, calcified ligaments, but perhaps he wants to remove the styloid because it’s calcified? It is not blocking the jugular. And he is doing my side with the pressure, which is the non-dominant side.
I am assuming your dominant side is not compressed??
He is saying it is the transverse process?. Is there a ligament involved?? Did he have your gradients??
You mentioned carotid artery compression is that still an issue?
Lots questions 
The dominant side is compressed 50% but had no pressures, so I’m not sure if that’s an issue. Will definitely bring that up when I speak to Nakaji. I will also bring up the calcified styloid and ligaments.
Hopefully he’ll give you time at your appointment to discuss all these things, you want to get the surgery done right, but he’s very experienced, and I believe the doctors who do this surgery check to see if the IJV re-opens okay afterwards to hopefully will check for any other compressions…
Hi Jules,
Yes, I want to get it done correctly. Thank you for your input.
I plan on bringing up calcified ligaments during the consult. Thanks again
So is he operating on non dominant side?
Do you have any issues with the cranial sinuses?? Eg. Transverse sinus?
Yes. The non dominant is the side that had the pressures. The dominant had no pressures despite being compressed 50%.
I also have stenosed transverse and sigmoid sinuses. Hoping those will open up. What is your experience with this?
Are both transverse and sigmoids both compressed?
Nakaji decided to do my dominate side 60+ % compression. My left transverse sinus stenosed With large ectopic arachnoid granulation above it
Left IJV compression but non dominant side.
His theory open up the dominant to improve overall better flow. Thus improving the chances that the Left transverse sinus would open up 9n its own. Interesting Dr. Mehta agreed to that . He did venogram and he also does brain stenting.
I am also questioning brachial plexus compression and possibly SCM. I was Left side impact from airbag…very high force hit!!
Way too many actors in this play!!
Am I convinced who knows…as Nakaji says we are the Pioneers…so much we do not know!!
How is your recovery going @Bmmac?
Hi there
Recovery has been slow. Not a lot of change yet. Wound has healed and tomorrow is week 5 post surgery. Sleeping better and no real pain unless I do too much then neck and shoukder pain.
The last few days noticing reduced head and eye pressure and less fatigue. Small gains. Follow up CTV in Toronto St. Mike’s in January and testing of eye pressure.
Thanks for checking in 
Is it an option for you to get your other side done? If that’s your problem side, that might make sense to do it.
Did you have pressures on the left side as well based on the catheter venogram?
I actually have narrowed transverse sigmoid sinus on both sides. I’m hoping Nakaji can get things flowing because this pressure is debilitating on me. Severe pressure upright and laying down.
Was Nakaji interested in discussing your accident? ? Or CCI?
Be sure to have all your questions ready based your venogram etc.
They don’t care about CCI. He maintains his resection of C1 is not cutting supporting structures.
You need to understand which side he is looking at and why. Review of all other issues…my case was left transverse sinus and large etopic arachnoid granulation above the left transverse sinus.
I spent 55 minutes with him reviewing my CTA with rotation on my first consult. I had lots questions. Another 30 mi utes in office reviewing Venogram .25minutes the week before surgery and 25 mins in the pre op.
Dr Mehta reviewed the issues with me post Venogram. Same diagnosis as Nakaji.
Have you consulted with anyone else? Constantino?
I am Canadian every thing was out of pocket. Plus 44% more due to the $
I can’t believe everything was mostly out of pocket.
The person that did my catheter venogram was absolutely wonderful. Same situation… Answered many questions. Several phone calls, probably three in total that were an hour long each. My husband and I wanted to make sure we know exactly what’s going on. Over and over he told us that it is my left occluded jugular That is the problem. The NIR was meticulous.
I imagine we will do the same when we are in Scottsdale.
Sorry you haven’t had much relief. Do you plan on doing the left side? Also, I’m wondering if you have pain in the occipital area? Not shooting pain… More like pressure. You said you had neck pain with your symptoms and I was just curious about that?
Who told you it was left side Nakaji
I started a few years back with sub occipitals pain. Had hydrodisection for that with Centeno Schultz.Denver
Nakaji was fairly clear it likely would not be a quick process. They don’t even suggest repeat CTV until 3 months
He felt likely one and done as did Mehta
Me less optimistic. But alot if my neck should issues are more likely Brach plexus and cervical plexus likely compression on jugular lower down