Yes he did it externally through the neck. Post surgery, I had some pain in my neck around the incision and some numbness there as well. That really only lasted for the first week or two but honestly was not very bad in general. I never needed to take the narcotics that were prescribed to me. Naproxen and ibuprofen were enough to manage it. I have had a lot of fatigue as well, but am getting back to my normal life very well. I would not say I have extreme fatigue anymore, but I would say I am still working to rebuild my stamina. I also had some dizziness. I did have a complication postop with a palsy of the right side of my face (Dr. Cognetti has never seen that before and heās done MANY of these surgeries). This is likely due to nerve swelling. I was on a high dose steroid for about a month, which I mention because that may be what caused most of the dizziness I experienced since I am no longer getting dizzy now. I will also say that Dr. Cognetti has been wonderful throughout this unexpected complication and I am still working with him and two other doctors who work with the facial nerve through Jefferson as I am still regaining movement on the right side of my face. I have been receiving excellent care!
Iām glad your are doing better and they are working with you on your face. Did you have any swallowing issues once your right ligament was cut and removed after surgery. Did you notice any changes once the ligament was removed that is a concern of mine bc I focus on that stuff. Like is your swallow the same and whatever it connected to can you tell it was removed at all? I lost the curve in my neck Iām hoping these exercises and chiropractor can get that back and maybe it relieves something.Thanks for responding
Glad to hear how helpful cognetti has been @Sammi . He really sounds like a great guy.
@musclecarguy the stylohyoid ligament does very little of anything functionally. It does very little in stabilizing anything (there are like 10 muscles attached to the hyoid already doing thatā and since it isnāt a muscle, it doesnāt provide much assistance in swallowing. The muscles are what are important, and if anything, calcified stylohyoid ligament just interferes with normal muscle functioning.
Iām not a doctor but this is just information Iāve learned throughout the forum over the past 6 months or so
Question so my left side below tonsil kinda of under back left part of tongue feels like something is there when swallowing saliva and sometimes not swallowing it also throbs often in that same location makes me feel like Iām going to choke but itās not in center and def not right side at all. It causes severe anxiety which only makes it worse. A mind of its on but I have it all the time. It doesnāt hurt sometimes achy numb Is my calcified ligament causing this.if I clear my throat it stops only to return in 15 seconds. It like desensitize it. Has anybody felt this had the ligament removed and problem solved?
Thank you
@musclecarguy - You said said you have no pain turning your head or swallowing & neither did I. My symptoms were like yours in that they were there most of the time regardless of my head position. The area youāre talking about back by your tongue that throbs is being caused by your glossopharyngeal nerve. I had that, too, & it went away when I had my left styloidectomy. I also had problems choking on food & drinks, not just the sensation I might choke. That is also a common ES symptom that went away after surgery.
OTC pain meds usually donāt help with nerve pain which is what your symptoms are. Youād need to get a prescription to Gabapentin, Amitriptyline, Carbamazepine or some relative of those which are used to combat nerve pain. They can take several weeks to start working. You can also try buying over the counter lidocaine patches to put on your neck in the areas where you have pain in your throat as those have been very helpful for some members. Some members have also had good results from taking a muscle relaxer. Those are also by prescription.
I think you will benefit immensely from your appt with Dr. Cognetti. It will answer questions for you regarding whether or not surgery might help, but with what I know & have experienced w/ ES, I expect surgery to remove your left calcified stylohyoid ligament will stop or vastly reduce your symptoms.
@Sammi - So great to hear about the progress youāre making! Iām glad your facial nerve is recovering & that Dr. Cognetti has continued to stay involved in making sure you get completely well. Thatās just plain old excellent doctoring!! 
@TML Thank you so much for the help youāve given @musclecarguy . I really appreciate the time you put in to helping break down what our membersā images shows.
[quote=āIsaiah_40_31, post:20, topic:20512ā]
Thanks Isaiah for your responses.
I had bottom left wisdom tooth extracted by dental surgeon( cavities)august 2024. Then 1 week later had top left molar extracted. Dental Surgery went well but had panic attack that night because on top freaked me out having that temp hole. I do have major health anxiety for many years. So the next month Sept 2024 had some more crowns dental work done on left side. By the end of sept the pain subsided from dental work but Oct 1 I started to get this throat sensation on left side mostly when swallowing but not ever painful. Put on many anxiety meds saying I was creating symptoms that it went from molar hole to old sensation from ā95ā. I did have this same issue after a case of strep throat which caused panic attack bc my uvula was really inflamed in 1995 after many doc visits thinking it was scare tissue from strep it did go away after couple years The doc in Philadelphia said it wasnāt Eagle syndrome i believe it was Temple back then but i new about Eagle back then and so did he.
I wake up every morning trying to figure out if its Eagle or not first minute nothing there then I get up go take meds with water and face starts tingling and throat begins its sensation under that back tongue area within 1 min. I didnāt have face start tingling until Feb and it does come and go but not painful but is there more now then Feb. I know anxiety can cause many things but it seems like the throat comes first then ton of anxiety. The benzos do not make throat go away! I hate them!! So this debate in my head of anxiety or Eagle is not healthy but i need someway to figure it out ?
You mention in post 12 (The curve of your left calcifications is surely putting them in contact with the nerves that are causing your symptoms.) The glossopharyngeal nerve (throat sensation )- Do you think the extractions caused this somehow I was fine before it . if so is any of this close to my left calcification on ligament because the calcification is higher on ligament I dont know if nerve is near that or lower where there is no calcification? Both Dental surgery were done went smooth.
I didnāt have any pain swallowing or feeling anything sticking in my throat, I did have tingling in my face though, & nerve pain along my jaw & in my teeth. We often see members who have had the onset of symptoms with dental work; I would guess that itās not the dental work as such setting these off (the trigeminal nerve goes to the teeth so it can aggravate that, but not the glossopharyngeal nerve as itās not in the same area), but more likely your head position during the dental work could bring the styloids into contact with different nerves. Especially if thereās alot of pulling with an extraction!
I understand your worries about the surgery, & there are some risks so it shouldnāt be undertaken lightly, but most of us get to the point that our quality of life is getting affected so much weāre okay with taking that chance, & with an experienced surgeon then generally those risks are minimised. How I would feel swallowing after surgery was something I was really worried about, but it doesnāt feel any different at all.
With your anxiety, you could discuss this with Dr Cognetti, whether thereās any anti-anxiety medication you could take before surgery that would help I donāt know?
@Sammi , Iām glad that youāre still seeing improvements with your facial muscles 
When I saw my local ent couple months ago he pushed in side my mouth and said yea I feel it I think you have eagle syndrome. What location on my ligament pic would he be making contact with? The section that is partially calcified hard or the section that is not calcified yet which is lower or some where else that he new I had it. Then got referred to Dr Cognetti
I would guess looking at the angle of your calcified stylo-hyoid ligament that could well be felt in the back of your mouth, where @Isaiah_40_31 has highlighted in pinkā¦
Did it set off any pain when he pushed on it? It quite often does, & thatās a good indicator that itās causing issues!
so it would be the calcified part then. I didnāt really feel pain but it was near my tonsil and i couldnāt not distinguish my throat bc pushing there radiated around but he was so quick i couldnt tell throat sensation changing
I would imagine it was the calcified section he felt, yesā¦some members poke about themselves to see if they can feel anything, if I pushed on the back of my throat by the tonsils it would cause the ES pain worse, it felt hard at the backā¦but we donāt recommend anyone pushes there too hard , it could make symptoms worse!
I have had none of my original symptoms in the month since surgery. I just said to my family the other day that I realized that I havenāt had any neck pain (aside from that around the incision area) or face tingling in a month, which is the first time that has happened since pre-2021. I also was really excited yesterday because I had no issues at the gym with floor exercises or exercises performed lying back. Pre-surgery, certain floor exercises and lifts where I was lying down would often make me feel like I was choking with my swallowing issues. I also feel like the post-op exhaustion and fatigue is getting better. Yesterday was the first time I felt up to going to the gym two days in a row since the surgery. My fatigue rate while working out or doing other things is still higher than normal, but itās definitely improved significantly. As far as noticing the missing styloid, the only thing I have noticed was a slight difference when I am singing, but some of that is also the face not moving as it should. But as a singer and voice teacher, I am very attuned to small changes. I think in the long run as I get back into singing more and more that this will be a change for the better, especially as my mouth movements become more symmetrical again. Part of my pre-surgery issue was that the styloid was likely making contact with my hyoid bone when I was singing, so singing was triggering some of my attacks, so I am very happy to not be dealing with that anymore at this point.