Consultation with Dr. Schindler

So I meant to make this post after my visit in May to Dr. Schindler’s office. But I have been changing jobs and really busy lately. I was have a video consultation with Dr. Schindler in about 3 hours from now. I was hoping to have this post done early enough to get feedback on what to expect, but at this point I figure I have all the tools I need and that I would just document my experiences to try to help others.

I saw Dr. March. I explained to her my symptoms of pain when swallowing, feeling of something stuck in my throat, right shoulder pain, etc.

I also told her you could feel it between my tonsil and cheek. I told her I had a CT scan and held up the disk. I could see the excitment in her eyes as she lept up sand said, “ooooh, yes. Ive been calling your doctor and they wont answer the phone or send over the scan.” They made of copy of it and returned it to me.

Dr. March seemed a little sketpical and insisted she do her normal analysis and that we could talk more about my suspected ES after she ruled out the usual suspects. I was open to that because it builds my case that I believe all else is normal. Looked in my nose, ears, throat, etc. Wanted to do an endoscopy but I told her I’ve already had one and it was all normal and I’d prefer not to.

She looked at my CT and said it looks like the styloid could be problematic but not everyone has symptoms from large styloids. I described symtpoms her assistant wrote them down. Told me that often times ES comes with a lot of other symptoms like blurred vision, tinnitus, nerve problems etc. I told her I didnt have any vascular symptoms or compression.

She eventually put on a glove and felt around. Didnt feel anything. I offered to guide her had to it as I have done before with my GF. She felt it and said something like “yeah, that is definitely not normal… does it hurt when I touch it?” I told her only if she kept pushing on it for a bit.

After that she seemed pretty convinced because of my symptoms, my ct, and her ability to feel it through the flesh.

She got kind of excited again and said it is really rare and she would like to be a part of my care beyond this because she wants to learn. She also said in a case like this it is usually easy to do an intraoral surgery because you can feel where it is located and it would be easy.

My GF intrerjected to ask, “doesnt that have a higher chance of growing back?”

Dr. March admitted that it does have a higher chance of growing back, but that it would be a much less invasive surgery because they would have to cut through a bunch of flesh to access the base from the outside.

She asked to do the endoscopy again just to expidite the process, saying they would almost certainly require one just to be sure before surgery. After feeling like I was getting somewhere, I decided to let her rule anything else out and bill several hundred dollars for an unnecessary procedure. I dont mind paying an unnecessary scope if I am actually getting something in return. I viewed it like cops trying to get their quota of speeding tickets… but at least I was being helped so I felt like they deserved the extra fees.

She then refered me to Dr. Schindler and gave me something in writing because I explained that I had never been diagnosed or anything, just bounced around from Dr. to Dr. and it would be nice to have it in writing that I am not crazy.

So I’m going to talk to Dr. Schindler soon. I figured there wasnt too much to prepare for at this point. I want to emphasize that I dont want my tonsils removed and that I have heard that the intraoral route, while healing faster, seems like a method that I prefer to avoid.

If I really don’t like what he says then I have a referal to Dr. Khatib as a backup. But I am feeling optimistic. Just a little nervous.

Thanks LWE Family! I hope this can help others know what to expect who are following in my footstepss on the same pilgrimage to a healthier life, as those before me have helped me.


Thank you for your follow-up post, @Kiriez. It does feel great to be right, doesn’t it!?! You did an amazing job advocating for yourself & it’s paying big dividends! I’m also happy to hear that Dr. March is interested in learning more about ES & being part of your treatment team. Kudos to her for being proactive in that arena.

I don’t know if Dr. Schindler does transcervical ES surgeries, but hopefully he’s flexible & will respect your wishes. You did a good job arguing against transoral surgery & actually, many of our members who’ve had that approach had slower recoveries than those who had surgery transcervically because the throat incision was irritated by swallowing food & fluids & in some cases became infected.

Please follow-up again with us after you talk to Dr. Schindler to let us know how your appointment goes.


I’m really glad that Dr March listened to you, & that you were able to educate her about ES, as @Isaiah_40_31 said, you did well advocating for yourself, it sounds like you could well have not got that diagnosis if you hadn’t been persistent.
I hope that Dr Schindler can help you & is willing to do external surgery!

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Seems like a very good doctor, not many off them want to go this way. Im happy that you’ve found someone that will support your case and also want to learn something aswell!


Update on my consultation with Dr. Schindler.

I had a zoom meeting with Dr. Schindler. He asked for my story.

I told him the slightly abridged version - that I started having throat pain that felt isolated to the right side near the roof of my mouth. Looked for help at my PCP in 2018. Tried controlling acid reflux and allergies but the symptoms persisted. Made life changes but the systems persisted. Was refered to an ENT. They said everything looked normal.

After a while I ended up finding a mass near the front of my right tonsil that felt too big and solid to be anything I have ever heard of while I was feeling around my tonsils to see if it was tonsil stones. Heard about Eagles Syndrome but wasn’t sure if it was the cause of my symptoms but stopped seeking medical help during the pandemic.

Jump to this year, the feeling of something stuck in my throat was driving me insane. I spent hours googling what could be wrong with me. I found another site about ES that described my feelings to a ‘t.’ I went to my dentist and asked the dental hygeinist about it without any mention of styloids or ES. She told me it was normal and from clenching my jaw. So then i went back to my PCP about 5 years after the first visit. She referred me to an ENT in town and I also asked for a referal to Dr. Schindler which landed me in the office with Dr. March. I believe everything that occured during that visit is listed above in a previous post.

So Dr. Schindler started off by saying that ES is hard to diagnose because there isn’t any one indicator that it is the problem. Rather, other problems should be ruled out until ES is basically the only explanation. He also said that surgery wouldnt necessarily help as it could be some other problem, and that surgery comes with risks.

He asked if I had any other surgeries before. Just a wisdom tooth removal and some minor dermatological “surgeries” to remove a cyst that was mainly just cosmetic.

He said that I have the right symptoms. And that from the CT scan the right styloid is definitely elongated. He said he measured the left one looks of normal length. So he had a pretty good feeling I was likely having symptoms due to the styloid.

But… he told me that he would like to verify and make sure by feeling around for the styloid that can be felt in my mouth. He said that usually in his experience his patients that can feel it in the side of their throat tend to “jump out of their seat” upon him making contact with it. And if that is the case for me that he feels basically 100% certain that the surgery would help me. But that based on what I have told him that he thinks I would likely be a good candidate for surgery.

I told him that Dr. March already felt around and confirmed it but that if he needed to himself that I understood. I also told him I tongue the thing quite often and it isnt so much of a shock so dont expect me to jump out of my seat in pain and its more of a dull/itchy pain feeling unless you rub around on it for a while (i havent tried pushing hard, seems kinda risky with a talon shaped object.)

He kinda winced as he realised and said that he somehow missed that the other Dr. had already confirmed it. He apologized and said that he saw it in the notes after that and also that she wants to be a part of the process to learn more, which he thinks is a great idea if I am on board. He said he has a lot of faith in her and that if the says she felt it then thats good enough for him. I told Schindler that I would love to help others learn from my experience and she would be more than welcome to join.

Dr. Schindler went on to say that he feels very strongly that an transoral/intraoral approach would be a better decision. He said that they wouldn’t have to remove my tonsils because the styloid (im paraphrasing) kind of goes past it towards the cheek. He said it would be a very simple process to make an incision, run a tool he called a curette (?) up the styloid as far back as he can get it, and then break the bone at that point and remove a significant portion of it. He chuckled a bit and said that pulling the bone out is kind of fun after breaking it off.

He went on to say the transcranial method is much riskier as more tissue has to be cut through and that there is a lot of very high value real estate in that area. He described it as like taking off the siding in a commercial jet and trying to cut a wire that is clustered in with a bunch of other important stuff and if you make a mistake the plane goes down. He said the healing process is a lot longer and that he thinks removing the whole styloid would be unnecessary.

He also mentioned the styloids are a lot thicker near the base and he would need a different tool(i think he mentioned like a drill and one other thing) that could be harder to use in such an important area.

I told him that I had heard kind of the opposite - a risk of infection that is different because it is in the mouth, and that removing just a portion of it may not solve my symptoms.

Dr. Schindler shook his head when I mentioned infection and said basically that the risk of infection from the transcranial is just as bad or worse. He explained that they feel that the transcranial approach would be for a more complicated and specific type of ES where there were nerves tangled around the styloid or something like that. I am assuming people with more vascular symptoms and compression.

He mentioned that the styloid is used in swallowing and that there is a ligament attatched to it, which I already knew. And that he would prefer not to try to remove the whole structure if it isn’t necessary to do so.

He told me that he gets probably around a dozen ES referrals every year, but that he only does one of two surgeries a year because they usually find something else that they think is the cause.

He said with my case, when you can feel it in the mouth and see it on the CT, and the symptoms + duration, that he feels like it would be one of those one to two cases a year he treats. He said he feels confident that I would be a good candidate for the surgery and that he feels strongly that I would feel relief from the process.
Also that since it is easy to locate in my mouth that it simplifies the approach over transcranial.

He said he won’t refuse to do the transcranial approach if I insist but that he thinks that it would be a really simple extraction through the mouth since you can feel exactly where to make the insicion.

He told me the stitches should dissolve on their own and that I’d be on a soft diet for a week or two. He said some patients felt relief before even leaving the office, which he found strange, but that many of them feel better within days. Told me I should have a sore throat for a week or two. He said I would go in after about a month for follow-up.

I told him I would love to take a chance at feeling normal again. He said his office would call me soon and we could schedule something but that he thinks he could have it done by the end of the summer.

All in all, sounds a lot like a wisdom tooth extraction to me.

I have a fear that my styloid could grow back with that approach, but Schindler seemed like he had a lot of experience and and I felt pretty comfortable talking with him, no bad vibes. He seemed like he was having a busy day but was very understanding and seemed to be most concerned with my comfort and well being, including wanting to take as little risk as possible to my health.

I forgot to ask him if I would be under anesthesia for the procedure and how long I would be off my feet. I don’t think I brought up what would happen if they ran into a problem with the oral procedure and couldn’t see very well. I also didnt mention anything about my right shoulder and arm pain as I am not 100% sure it isn’t from posture / repetative motion and lack of stretching.

With a Dr. as experienced as Schindler, I kind of figure he knows what he is talking about and I can trust him more than a pill-pushing PCP.

But I was probably going to message him a few questions about recovery and the procedure itsself.

So what do you guys think? I feel pretty good about his offer. But many of you have been down this path and I value your imput as well. Do you think I should mention it hurts to sleep on my right side, and see if he thinks it has any connection? Are there any glaring omissions that you noticed?

I kind of want to go back and read the report of the 17 year old on this site that had a procedure with Schindler again.

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It sounds like you had a good consult w/ Dr. Schindler & it definitely sounds like he knows what he’s talking about. I must say that we do have members who’ve had great results from intraoral ES surgeries & have had no styloid regrowth so intraoral isn’t always a bad way to go especially w/ an experienced surgeon. However, some of what you wrote brought up questions in my mind:

Since his way of shortening the styloid is to BREAK the bone, does he go in & smooth any jagged edges that are left behind? Breaking the styloid off does not leave a nice smooth surface on the remaining part of the styloid, & rough edges can be irritants going forward after surgery.

I disagree w/ the statement that transcervical recovery takes a lot longer. We’ve got repetitive patient evidence that both approaches to ES surgery are slow to recover from due to nerve recovery being slow, & the initial recovery (i.e. first month) from intraoral surgery is typically more painful. Most surgeons these days leave 1 cm of the styloid or a bit less which means they’ve removed most of it. It would be interesting to know if he can estimate how much he leaves behind.

The surgeons who do transcervical surgeries typically use a tiny bone saw (rongeur) to cut the styloid. Minimally Invasive Cervical Styloidectomy in Stylohyoid Syndrome (Eagle Syndrome) - PMC

I disagree here, too. We’ve had several members who had transoral surgeries end up w/ infected throat incisions, but almost no one has had an infected neck incision.

There is no way for Dr. Schindler to know if you have a nerve or nerves tangled around your styloid prior to your surgery. This situation is not visible on a CT scan so is discovered during transcervical surgery when the surgeon can actually see the styloid & the soft tissue surrounding it. My glossopharyngeal nerve was wrapped around my styloid, & that wasn’t discovered until I had my surgery. It needed to be unwrapped so the styloid could be removed. I can’t imagine the pain I’d be in today if I’d had intraoral surgery, & my styloid had been broken off & removed through my throat w/ my GPN wrapped around it. I admit this is a worst case scenario, but it’s one reason I’m a strong advocate of the transcervical approach.

I apologize for expressing my opinion so strongly but there are two sides to this argument. If you feel comfortable w/ what Dr. Schindler is offering you, please don’t let my opinion sway you. The doctors who do these surgeries will most likely never have to endure ES surgery or the post op recovery themselves so they can only speak from their experience as surgeons. I feel they often downplay post op recovery because they’ve never had to go through it.


He sounds very kind and it’s good that you feel confident with him, we have had members who have had successful surgeries via the intra-oral method. I agree with @Isaiah_40_31 that you should clarify if he’s able to smooth the broken styloid off, that would be important to me. And also that doctors underestimate recovery, but that’s the same for both surgeries.
Most members don’t notice any changes with swallowing after surgery, usually the ligaments are stripped from the styloid to be able to remove a reasonable part of it. Do you know if it is just your styloid which is elongated, or if you have any calcified sections of your stylo-hyoid ligament as well? If so that would need removing too or otherwise you could still have symptoms. It doesn’t sound as if you have any vascular issues, so I agree with Dr Schindler that an external surgery would definitely be better if that was the case.
Let us know what you decide!


@Jules I havent seen any calcifications in the CT scan, just the elongated styloid.

I’ll reply to @Isaiah_40_31 in the next couple days. I really appreciate the feedback and the concerns, and need a little time to pour over the information you have given me.

Thanks to both of you for your support and sharing your experiences.