Can anybody help me to confirm if my CT shows elongated styloids?

Good observations, @Lababila - especially your comment about extra muscle tension in the neck causing ES symptoms to flare. Definitely makes good sense.

Good evening all.

Today I received the report from my CT venogram, reported by Dr Higgins.

It stated:

The intracranial venous sinuses appear patent. Both lateral sinuses are about equal in size,
although neither transverse sinus is particularly generous. The sigmoid sinuses appear
unremarkable.
There is very marked narrowing of both jugular veins between the styloid processes of the
skull and the transverse processes of the C1 vertebra. There is also quite marked smooth
narrowing of the internal jugular veins more inferiorly behind the sternomastoid muscles at
about the C6 level.

Dr Axon then added:

As mentioned in my last letter, this is not a hard sign for raised intracranial pressure, especially as
there is no evidence of raised pressure on intracranial imaging.

I do not believe Mr Axon will be willing to offer treatment for this, as it appears his position is that despite the evidence of narrowing of the veins, and my symptomatology, there is no sign of a problem.

I will now be looking to alternative surgeons for an opinion on whether they feel surgery will be beneficial. I would value any opinions on this.

As I see it currently my only real options are

Dr J Hughes, it appears to me he would likely operate to remove the Styloids, but unsure whether he would do a C1 shave if indicated from the scans.

Dr Timothy, who will likely only do a C1 shave and not remove the Styloids!

I do not know whether there are any other options? Preferably I would see a surgeon open to both options and having the capability to do whichever is most apparent during the surgery itself.

I have not yet received the scans themself. A word or advice to anyone getting scans done at spire hospitals, they will give you a copy of your scans on the day and time of your scan if you expressly request it there and then. But as soon as you leave, you then have to make the request via the medical records department who takes up to 30 days to action your request and are very difficult to contact! Not great service when paying high prices to go private!

I would value any thoughts on the impact of the sternomastoid muscle, and any therapies which may alleviate this. I have read that myectomy is an option ( essentially removing part of the muscle). But wonder if physiotherapy may assist here?

Thanks all

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That’s so frustrating getting a report like you have & Mr Axon still being unwilling to operate! I wish I could give you an answer about who’s best to see but as you say neither Mr Timothy nor Mr Hughes would likely do the styloid & the C1 shave; we’re a bit stuffed in the UK! @KoolDude has had styloids removed, and then a C1 shave with Mr Timothy but is still having some issues, you could message him about his surgery experience…
@vdm has posted lots of info & links about neck, shoulder and back muscles and how posture can affect them, with links to pt videos which you might find helpful, have a look at this discussion:

Thinking of you :hugs:

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Hi what is ivj?

Perhaps a typo… iJV is used to refer to internal jugular veins though