On September 29, I had a consultation with Dr. David Nazaretovich Nazaryan (maxillofacial surgeon) from Federal State Budgetary Institution “The National Medical Research Center for Otorhinolaryngology
of the Federal Medico-Biological Agency of Russia”
House 30, building 2, Volokolamskoe shosse, 123182, Moscow, Russia
Phone : + 7 499 968 69 12; E-mail: otolar@fmbamail.ru www otolar-centre(dot)ru/en/
So. He is ready to remove the calcified stylohyoid muscle, as well as possibly the posterior belly of the digastric muscle. He said that they sometimes resect the posterior belly of the digastric muscle.He refused to resect the large horns of the hyoid bone and does not believe that the problem is there. He also warned about the danger of hyoid bone resection. I took time to think (I’m considering surgery with him, but I also want to consult with other neurosurgeons)
But usually it removes only the styloid process, it does not even cut off the muscles attached to the styloid process. This is usually done by all maxillofacial surgeons who remove the styloid process.He has a lot of experience in this. I found out how many people he has operated on at the moment (surgery only on the styloid process, without other operations). He has already operated(surgery) on more than 500 (five hundred) people.
Also in the doctor’s office, I met two people who had their styloid process removed on one side (a 48-year-old woman and a 30-year-old guy. I saw the scar on their neck, so I went up to them and asked them questions)
The woman complained mainly of pain in her ear and jaw, and when raising her arm, pain in her neck and shoulder blades, Lump in throat, and trouble swallowing. She also sometimes had pulsate tinnitus.She also sometimes had a slight dizziness (rather a feeling like alcohol intoxication) Sometimes after eating, sometimes when washing dishes (head in a certain position). In June 2026, she had the styloid process removed on the left side (one side). All her symptoms are gone (there are no more symptoms) . There were only symptoms of a lump in the throat, as well as numbness in the incision area (this is for everyone after surgery).She had a follow-up appointment with Dr. Nazaryan to have the styloid process removed on the right side(although it is not currently causing her any symptoms . She is 48 years old and she does not want the styloid process to start giving symptoms over time, over the years. Therefore, while she is 48, she wants to remove the styloid process on the right. That is, she does not want to have surgery when she becomes a grandmother-it’s hard.)Dr. Nazaryan ordered her an operation on the right side, she is happy)))
30-year-old guy. mainly of severe dizziness occurs periodically , sometimes blood pressure spikes, pain in her ear and jaw, Lump in throat, and trouble swallowing. He had an styloid process on the left, measuring 8 centimeters, as he said on CT scans it was clear that the styloid process was compressing the internal carotid artery. He also had his styloid process removed in June 2026. All his symptoms are gone (there are no symptoms).After the operation, he has numbness in the incision area, and as he crawled, the pain of three bites while eating.
In general, the improvement statistics after the removal only of the styloid processes are about 70-80% (positive effect), but the main complaints(symptoms) of patients are pain in the ear, jaw or neck and problems with swallowing.To a lesser extent, patients have symptoms (fewer complaints) such as dizziness and pulsate tinnitus, and mainly innervation of the Superior cervical ganglion or Plexus caroticus (these are the main nerves that can innervate and give symptoms such as dizziness, palpitations, pressure, and even possibly head fog, and a lot other symptoms ). Since the end of the styloid process can innervate only these nerves (Because the vagus nerve is located on the other side of the carotid artery and between the internal jugular vein and the carotid artery.). It is possible that the base of the styloid process and the transverse process of C1 may compress the vagus nerve between them (when the distance is very small), or tension on a branch of the vagus nerve may cause its innervation (but these are unlikely situations). And very rarely, dissection of the internal carotid artery and stroke.
Regarding symptoms of head fog, intracranial pressure, possibly dizziness, headaches, suffocation, and so on (vascular symptoms/specifically related to veins) . Removing only the styloid process is a sufficient surgical procedure in 50% of cases the of patients with compression IJV. Further , in 70% of cases , removal of the styloid process and resection of the digastric muscle and maybe muscle oef the styloid is sufficient to solve the problem with IJV. And there is no need for C1 resection. Nevertheless, C1 resection is sometimes required in 10-20% cases (in the case when the accessory nerve is pinched (it is stretched ) or the occipital artery. Narrow jugular openings are also found in 10-30% , and compression is higher than C1 between the muscle and the root of the styloid process . And C1 resection is partially successful at decompression (if the muscle is cut off and it no longer interferes with the vein). As a result, C1 resection in the case of a very low jugular opening(foreman) has almost no chance of success (with a narrow jugular opening/foreman, the chances of successful vein expansion are negligible. It is necessary to solve the problem with the jugular opening/foreman or expand the emissary veins (vertebral veins)). But these are rare cases.) But that’s my opinion, and I’m not a doctor))))
In Russia, many surgeons remove the styloid process , but Dr. Nazaryan has the most extensive experience in removing the styloids:
www.neurology(dot)ru/en/ (Research Center of Neurology
Viktor Aleksandrovich Lukyanchikov — neurosurgeon,
Kiselyov, Andrey Anatolyevich. Position: Neurosurgeon
- Address: 80, Volokolamskoye Shosse, 125367, Moscow, Russia
Alexey Yuryevich Drobyshev maxillofacial surgeon
Alexey Sergeevich Dikarev — maxillofacial, plastic and reconstructive surgeon, oncologist
Ara Sargisovich Khandzratsian. Head of the Department, maxillofacial surgeon (inozemtcev(dot)ru/employees/handzracjan-ara-sargisovich)