So none of those remarks should be huge causes for concern? My provider says my symptoms don’t quite fit with either and said it could be atypical migraines.
I have my TMJ assessment in the morning and I’m going to ask the Dentist to look for ES since a lot of people are diagnosed in that manner.
I also have the ultrasound of my carotid tomorrow afternoon. Could that show ES effects if it’s vascular ES?
I’m just going to keep on keeping on and try not to stress!
This is the BEST possible strategy, @BLPICCOL71! The two strategies you suggested i.e. asking your dentist to look for your styloids. If they’re elongated, they will show up in a CBCT scan which many dentists have the equipment to do & which your dentist will do if checking your jaw joints. Getting an US of your carotids could possibly show the effects of the styloids on the carotids especially if they’ve been poking them or rubbing on them. Don’t be discouraged if the US doesn’t give you any definitive results though. The CBCT at your dentists is likely to be more helpful.
Re: your MRI results - it would be best to go over them w/ the doctor who ordered the MRI & ask questions of him/her. Since we’re not doctors on here, we really can’t tell you for sure that the MRI results are insignificant. On the up side, though, if there is something suspicious or glaringly wrong, it would be noted as such & additional scanning or follow-up w/ a specialist would be recommended.
The dentist is referring me to another dentist for a differential evaluation and said the other dentist can do a 3D cone beam CT. That appt is 9/23.
Just finished the ultrasound of the carotid too and it was like the technician was literally following my pain in the neck!
Thank you for the feedback and encouragement so far, it really is helpful!
It sounds like your dentist is interested in helping you get a diagnosis & the US tech, too! I’m so glad to hear that!! I hope between the US results & the cone beam CT (CBCT) scan you will finally know whether or not your styloids are causing/contributing to your symptoms.
When I went for the CBCT scan their machine was down, ugh! But the dentist looked at my pano and did a TMJ assessment and ruled out TMJ. He wants me referred to an ENT to follow up on ES. I got the referral and asked to be referred to Dr. Greg Krempl. I should know this afternoon or tomorrow if they can refer me to him. We might have some progress after all!
That’s really good, hope you hear soon 
So I ended up seeing Dr. Krempl in December 2024 and he said I was a surgical candidate but the chances of symptom relief are 50/50. I didn’t opt for the surgery back in December but I have since went back recently and opted in for the surgery. I am scheduled for bilateral removal of the styloid ligaments externally on Monday, 8/11/25. I feel really good about Dr. Krempl, he does 6-20 of these a year and has done over 200. He primarily does cancer surgeries in the ENT area so I feel like he’s very familiar with the anatomy in the area and doing surgeries in this area. I think he is the only one who does the surgery in Oklahoma. Anyway, I think it’s worth the risk to try and get symptom relief and also for things to not get worse in the future. I have calcified styloid ligaments on both sides all the way to the hyoid bone, the right side is more calcified than the left but I have symptoms on both sides. Dr. Krempl said the risks are what any other surgery has and a 1% chance of nerve damage. I think he is very conservative on committing to saying there will be symptom relief and I like that to be honest. He did say when showing me my CT that I am the ideal candidate for this surgery and it is the imaging he wants to see for a patient electing for this surgery. I have been dealing with symptoms since late 2023, so almost two years and I’m ready to give it a try. I’ll update after the procedure.
Good that he thinks you’re a good candidate for surgery- has he been doing bilateral surgery for long? Not many doctors used to do bilateral but more seem to be offering this now… Praying that all goes well, I hope that there’s not too much swelling or pain after surgery & that it improves your symptoms. Let us know how you get on when you’re up to it! 
He said he can do one side at a time for a 90 minute procedure and he said he’s 100% comfortable doing bilateral. I’d rather just do one operation instead of two so I’ve opted for the bilateral procedure. Dr. Krempl seemed to think there wouldn’t be much swelling or pain after surgery and he said symptom relief if it occurs should be pretty immediate. It’s outpatient and two days of true recovery (doing nothing but resting) and two weeks of nothing more than 20 lbs of lifting. I’ll definitely update the group. Praying it gives me great symptom relief!
Great news that your surgery is coming up soon, @BLPICCOL71. I’ll put the date on my calendar so I can pray for you & Dr. Krempl that day.
I’m sorry to have to say this, but the healing window Dr. Krempl has given you is quite underestimated. With bilateral ES surgery you will most likely be pretty uncomfy for a couple of weeks at least (max post op swelling occurs 3-5/6 days post op - stick w/ icing your neck every couple of hours for at least 15 min & take your pain meds on schedule & sleep w/ your head elevated to ~30º during this time).
Nerves that have been irritated by ES can take up to a year for full recovery though by 6 months after surgery, you’ll pretty well know how your nerves are healing. Post op swelling may take 6-8 weeks to fully subside, & it’s usually a big contributor to post op pain because it puts pressure on the nerves as they’re trying to heal. Additionally symptoms can come & go for several months after surgery & some may linger longer than others. This is normal, but makes some people think surgery didn’t help resolve symptoms.
If you elect to take prescription pain medication, you’ll also need to take a stool softener & laxative daily to keep from becoming constipated as opioid pain meds are notorious for causing that problem.
Please do update us once you’ve had surgery. If you have questions about recovery, please ask. We have answers. 
@Jules @Isaiah_40_31 Thank you both so much for your support and feedback during this process and thank you for the prayers!
Surgery went well, I have attached the procedure details…pretty in-depth and cool to read.
Day of surgery feedback; Swallowing is pretty painful (similar to a very bad painful sore throat), this got worse thru the night where I dreaded swallowing, it got kind of hard to talk, decent swelling and bruising but I bruise easy (attached pictures), I noticed my lower lip quivered when I full smile and kind of droops on the left side, and my bite felt a tad off on my right back molars. I had a very difficult time getting comfortable sleeping on my back, didn’t matter how flat or lofted I was. I found lying on my side with a low loft pillow gave me the comfort to sleep a few hours, I probably slept 4 hours total but I feel pretty rested.
Here’s the good news I’ve experienced so far; it seems like my finger tip numbness is gone, inner ear fullness and sharp pain are gone, I have a better range of motion turning my head but the swelling and incision are what is inhibiting it for the time being, and the pain below my ears and behind my ears is gone too. The swallowing today is still pretty painful but seems to be getting better. My lower lip quivering and drooping seems better today too. I think as time goes on I’ll just feel better and better! I think icing is my main tool to make the swallowing feel better and I’m going to ice a lot today.
I’m so glad I went for the surgery! It is a terribly difficult decision especially when the doctor says 50/50 shot of symptom relief. I wish I would have done it sooner but I’m also thankful for the lessons I’ve learned along the way.
Oh yeah, Dr. Krempl is amazing…I felt so comfortable with him being the surgeon! He didn’t promise anything and explained the procedure in a way that made me 100% comfortable. What a God send!
I’ll keep updating as I heal. Much love!
Your incisions look really great @BLPICCOL71, & from the surgical report it sounds like both sides were pretty straight forward. You had very long styloids so I bet your neck is doing a happy dance 
(or at least it will be in a few weeks 
) because those things are gone! It’s great to hear you already have some symptoms improvement. Your throat will feel a bit better each day & your lip should fully recover over the course of a few months if not sooner.
I look forward to your updates!
Well, they certainly removed a nice long piece of styloid & ligament each side, so that’s really good, & as @Isaiah_40_31 says your incisions look very neat! I’m glad that you’re seeing some symptoms improve already, that very good news…days 3-5 can be the worst for swelling, so try not to worry if you feel rougher later, the recovery can be a bit up & down…get lots of rest, are you able to eat at all?
I ate really good right after the procedure but as the day went along and last night I could hardly swallow. Today is much better and I’m able to eat soups.
I slept really good last night. Side sleeping still seems the best which is weird because I couldn’t side sleep at all before the procedure without pain. I normally use a CPAP but have not used it the last two nights, going to try tonight. Kind of hoping the calcified styloid ligaments was why I have minor obstructive sleep apnea but we’ll see. Pain in throat and swallowing has gone down a lot and I was able to eat a regular meal last night. I have an appt. Monday 8/18 to get my stiches out. I already ordered a cream I hear is good for minimizing scarring, link below.
https://www.amazon.com/dp/B00G17U5K6?ref=ppx_yo2ov_dt_b_fed_asin_title&th=1
Is the lower lip thing common after this procedure?
Lip drooping is really common after surgery; it’s usually because the facial nerve has been irritated during surgery - it’s very fragile & easy to stretch- & this does resolve with time, lots of members have had it.
Glad that your pain has gone down lots & that you can eat!
Just found this picture. I believe this is the styloid process part and not the entire styloid ligaments that were removed.
Those are some long styloids, @BLPICCOL71! I’m glad they’re out & you’re recovering well so far. The cream looks interesting but is pretty pricy. You shouldn’t start putting anything on your incision until after it has healed i.e. ~4 weeks post op. Do let us know what you think of the scar gel once you use it.
I bought the cream but am going to ask my provider on my post op appt Monday when I can start using it. I get my stiches out Monday. I didn’t have to take any oxycodone yesterday for pain, just ibuprofren. Swallowing is almost normal and I’m eating a regular diet again. Still pretty sore and stiff around the incision points.
