Hi Brilliant Eagle Forum,
Sorry for all this detail. It’s been many months since I first found this excellent forum and posted something, having had undiagnosed chronic symptoms for the last 3+ years (still have) & wondering if ES is to blame for some of them, as getting no closer to diagnosing & solving things after a range of tests. I’ve been dismissed by doctors so far but eventually a neurologist (not familiar with ES) did listen 10 months ago and ordered a CT neck scan with contrast (& MRI for terribly heads & vision symptoms before then). The bony thing sticking into my throat cavity by the tonsil on the Right Side seemed a clue, presuming it’s the styloid at an angle, which made me push for the scan.
I only recently received the letter following the scans this year; the CT report was only a couple of lines & said: satisfactory appearance of the pharynx, larynx, thyroid gland, mediastinum & lung parenchyma, no significant bony abnormality & normal appearance of the hyoid bone. No mention of styloids. Thanks to Andy on here I downloaded the RadiAnt app & have been through the 3D images & copied some which show the styloids so shall try and include a few here. I’d be very grateful for any feedback. Totally understand this forum does not replace the doctors, but hearing your opinion & experience is also invaluable. From what I can see, the Right styloid is longer than the left one, (perhaps up to 5cm long? With the Left one perhaps less than 3cm?) & on some images looks like the Right one may be impingeing on the carotid artery/sheath and/or other vessels & vagus nerve? which could explain some or all my symptoms. But I don’t know, hence would be very grateful for any feedback. Also it looks a bit bent in some images & not others, but could fit in with it protruding into the throat cavity, which I think I can see in one of the images (I can feel it very prominently down my throat with my longest finger, by the tonsil sticking in the cavity). I’m a novice trying to interpret scans, though have been looking things up to try and learn more, so at least I’d hope to know what to talk about, but would be very grateful for some feedback as some of you are so experienced & knowledgeable. It would really help me in talking to the consultant about it, having this proof (if it is ES) after they said the scan was normal.
[To recap from before, the chronic symptoms include a very thick throat feeling constricted all the time (not sore throat like an infection); painful aching larynx when talking (comes on the more I talk) & croaky voice; breathlessness/tightness in throat with dry tight cough feeling ill at the slightest exertions (not been able to do anything aerobic for last few years); the throat is much for sensitive & does get very sore with fumes etc.; occasional bad tachycardia episodes (plus extremely high BP, but that’s improved on BP pill); weak painful neck when holding good posture (feel need to slump the head all the time), occasional swallowing issue, have to watch eating; feeling something’s in the throat; occasional acid reflux; eyes very sensitive to light & ears sensitive & can ache; urinary incontinence; abdominal bloat/weight gain; once in a while some numbness back of tongue right hand side & front of tongue; (had horrendous sledgehammer headaches but they seem to have gone away on their own since last year); go weak in the legs, tired & brain fog. Also occasionally when moving head a certain way get a sudden stabbing pain on the same Right front side - either halfway down the neck, or just below the ear. ]
Thank you so much for running this forum. I’ve learnt so much and at least feel there are people who understand & can help those with ES and those of us wondering if we have it have it.
5 images follow. (Can add more if not clear)
Huge thanks! 
@Blodyn - Your right styloid is downright scary looking, thick at the top & long & pretty pointed at the bottom. It is quite long & curved so is most likely causing many of the symptoms you’ve mentioned. In the first image, it also looks very close to the transverse process of C1 so there’s a chance your IJV is also being compressed which could explain your brain fog & past headaches.
It also sounds like your vagus nerve is irritated w/ the gastrointestinal, bladder, heart, bp, breathing, coughing, & vocal issues you have. Obviously there are also other nerves that have been affected. Tongue & throat symptoms can be from the glossopharyngeal nerve & ear aches can be trigeminal nerve related. Neck pain can be from the accessory nerve though this one also usually causes shoulder pain, too.
Another thing to note is how straight your neck vertebrae are. The cervical spine is supposed to have a lordotic curve. This curve develops in infancy as a baby begins lifting its head while lying on its stomach. As adults, due to poor posture & also to the fact we do so much of our work & play looking down, many people lose that curve which causes muscle compensations that result in chronic pain for some people. For those of us w/ ES the lack of a cervical curve can bring elongated styloids into closer contact w/ nerves & vascular tissues thus causing significant symptoms.
vdm posted a lot on the topic of “military neck” as it’s called. Here are a couple of threads that he put together over time that are very informative on that topic. Military neck can be reversed via physical therapy, but it’s a slow process.
Hi Isaiah, extremely grateful for you comments, that’s such a help. I did read some things, funnily enough, the other day on military neck, so shall look at what you’ve sent too. Could well be part of the issue.
Can’t see the border of the throat cavity on the scans, to show the right styloid actually pushing into it by my right tonsil, but does it look like that to you? shall look again the 3D images. An presuming it does look like ES then.
Not to worry! - just seen an icon by your name that says it’s your BIRTHDAY today!? All congratulations - and you deserve a gold medal for your superb contributions on this forum. Thank You again 
Your story shows just how crazy dealing with Eagle Syndrome is for sufferers. You clearly have a problem. It is possible to ask the ordering Doctor of the CT scan or another Dr for a rereview of your CT for a second opinion. Also, you can ask if there is a radiologist that knows how to identify Eagle Syndrome. You could include one of your scans with the problem circled.
As an example, I have a Orbital CT scan that clearly shows the problem but the radiologist said nothing. A Neuroradiologist picked it up on a CTA scan but a neurovascular surgeon missed it and told me he saw nothing to indicate there was a problem with my jugular before the report was written.
You also might want to try the different settings on Radiant to see if it helps show things. For example, I saw a user here that used the black and white setting and felt like it showed her/his problem better.
I agree that your styloids look pretty long, especially the right, & does look likes it’s pretty curved inwards. I think you could be right that it could be irritating the carotid artery sheath, & as @Isaiah_40_31 says, it’s close to the C1 process so could possibly compress the IJV- although your right IJV looks smaller than the left one- lots of people have a dominant & non dominant IJV, if the non dominant one is compressed it causes less symptoms than if the dominant one is compressed…
It’s certainly worth pursuing as a diagnosis, & could be what you feel poking you in the throat. I just can’t believe given your symptoms & the reason for having the CT, the radiologist didn’t even comment on the styloids, I despair! As @JugularEagle says, whether you’d be able to get the scans re-evaluated? Idk if the NHS will do that, but when it’s not been even looked at properly?! Or if you’re going for a follow-up appointment with the neurologist, maybe you could print out or have ready on your phone some similar images of styloids and ask the Neuro about diagnosing you?
Dealing with NHS probably makes it more difficult. They do have PALS.
Thanks very much, that’s a great help and I shall do what you suggest and ask the Dr who ordered the scan about a review & referral to a Dr with experience of ES. Your own example is very telling…
Since I posted, I’ve tried different settings & things on Radiant - it’s a Brilliant app! But will try what you suggest too with B/W.
Huge thanks again. Hope you’re doing all right yourself
Thanks so much, Jules. That’s all so helpful & informative. Fortunately I’ve had a followup appointment come thru with the neuro for early January, but plan to send him some snaps from the 3D CT images, like above (but have found some better ones now) & some comments & more info & go through him, as at least he listened & did order the scan. He may be able to involve an ES doc from another health board then. Actually showed things to the GP today, who was one who dismissed it before, but she took a lot more interest today & was keen to find out more. She couldn’t refer me directly to the ES (very few) specialists on your list as they’re in another health board, but she said local specialists can refer on. So, yes, going to show him (with arrows!) the styloids & ask more questions.
It’s definitly the Right styloid that is longer. it’s not clear as I cropped the Right & Left markers off the sides and on some images the Right is on the Left!
I know ES isn’t itself always a big problem, but all I want to know is if the longer styloid is affected any of those blood vessels and nerves in the neck. My symptoms make me wonder about some IJV compression that you highlight. So yes, I’ll follow it all up. Thank you very much once again. It’s a relief having you & Isaiah & Jugular commenting so helpfully and I don’t feel like a fraud now either!
A poster here (I can never remember how to spell the name) notated my flat CTA pic where the the jugular is trapped. I used the exact image that the neuroradiologist had referenced. Other posters here know what they are looking at but using mine as a reference I would be surprised if you don’t have jugular compression in the C1 area at least when you turn your head. It looks similar to mine but mine was taken in the neutral position. So what I am saying is that if your jugular is not as big as mine and the styloids are not as wide as mine and thus not causing a problem in neutral position it might when you turn your head various ways.
Maybe you will get lucky.
JugularEagle, that’s all very interesting to ponder on. It makes sense what you say, so I’ll bear it all in mind & see what transpires. Many thanks again
Thank you, @Blodyn! It was my birthday! I spent the day driving as my husband & I are moving to a different state that is about 1650 miles from where we currently live. We’re initially moving our possessions by ourselves but will get help from a moving company later. I’ll celebrate when we arrive at our destination on Wednesday! 
O Wow! Big things happening indeed! Hope you enjoyed your special day, even if it was largely travelling… That sounds like a Major Move you are making - but how exciting! Wishing you all the good fortune & strength for it all to go smoothly, meanwhile - travel well!
Congratulations @Isaiah_40_31 California is losing a great soul. Good luck on this next chapter.
Thank you @Blodyn & @Chrickychricky. My husband & I are both California born & raised, but it’s not the same place it once was. We’re leaving Silicon Valley as it’s like living in Los Angeles now & heading to a less populated, less stress driven state in the Midwest plus we’ll be closer to our daughter & her family.
Speaking of climate change, we’ll be in the midst of our own climate crisis going from moderate CA winters to REAL subzero winters. I’ll need to learn how to drive on icy, snowy roads. Old dog, new trick. 
Looking forward to the adventure!
Sounds exciting though! All the best of luck, sound health & good fortune! Thanks again for all your brilliant comments on this forum. You’re so diligent, helpful, knowledgeable & care about us all. Go well .
Thank you, Blodyn! 
