Diagnoses

My ENT got results of my ct scan with contrast and she was a little upset, she specifically wrote down the reason for the CT scan was eagle syndrome to get a diagnoses. She said the radiologist didn’t even mention it in his report. So from what she showed me on the scan I have a large area of calcification in my neck. She said she can’t tell exactly where it is but it looks to be running between both carotid arteries. Also it looks broken up and isn’t just a solid calcification. Therefore she doesn’t know if it’s the stylohyoid ligament or if it’s the actual process calcified. Has anyone else had calcification that is broken up? If I can figure out how to post a picture of the ct image on here then I will. Also I am having some dental procedures done and had a cone beam ct scan done today. Can those show the styloid and the ligament better? When I mentioned Eagle syndrome to the dentist he said he had never heard of it and never saw any cases of it. I also saw an oral surgeon years ago that told me I had eagle but I had no symptoms then and forgot he had even told me until years later.
121-image.jpg (3.33 MB)

You really need a 3D CTA for a definitive diagnosis.

I would push back to the ENT and tell them the purpose of the CT was to review it for Eagles Syndrome. Make that doctor be an advocate for you and have the Radiologist do what was requested. Tell them you are not paying for a CT without a proper report. I have found that just about every scan I have ever had done I have to make sure they do right. There has been an issue with almost all of them. If you feel comfortable insist on a report commenting on specifically the length of your styloids and any calcification.

Also, April E is right that a 3D CT is best, but you may have some luck with this dental xray you had done too.

A dental CBCT scan shows the process quite exquisitely. Make sure it is a full scan as they can limit the size but this can lead to part of it not being exposed.

CBCT is different from CT but both show 3D images. A CT can show the soft tissues a little better if it is calibrated to do so.

Many people have calcified stylohyoids and I see them routinely on dental imaging. I’m amazed how many report no symptoms. Conversely I’m also surprised how many health professionals are unaware of the disease or take the time to research it. It was part of my basic dental degree education. But more of a footnote as it is relatively rare or at least rarely reported or found. But it is in the medical and dental literature if someone just types it into a medline search.

Thank you all for your responses. Our radiologist that the hospital I had the ct scan done at I don’t think much of. I went in a few months ago with severe pelvic pain and the report showed I had a 4.5 cm teratoma tumor and I had pain for almost a year. Gyno said scar tissue but since the report said tumor I had a complete hysterectomy and when he got in there I did not have a teratoma tumor as the radiologist had noted on the report. So the radiologist isn’t very good in my opinion.

Just wanted to point out that while a 3D CT scan is considered the best, you don't need one to get a diagnosis for Eagles. Drs. Cognetti, Samji and Forrest told me this. Drs Cognetti and Forrest said a regular CT scan (without contrast) was fine. I thought you needed a CT scan with contrast as least. Maybe since they are the most experienced doctors, they can see significance where others can't - ?

Also, I know other people have posted scans that looked like their styloid was in pieces. I remember a conversation about it, but I just don't remember when it was. But I think the result was something like some of the styloid isn't as calcified as the rest, so just those very calcified pieces show up, even though the styloid is actually intact. I don't really remember, but I remember there was a valid reason why the styloid appeared in pieces like that.

My left styloid is mostly intact but is in pieces like yours down closer to the hyoid bone - a variation on your theme.

:)

Based on my knowledge (experience), there is no special machine to do a 3D CT scan. The tech uses the CT scan to create a 3D image using software. It can be done so long as it is requested by a doctor and they have the software to do it. Also, any doctor can look at the CT and see the styloid elongation. And whichever doctor you choose can have their own radiologist look at the scan and do the calculations if you need more information. You don't have to repeat the test to get the information you need.

I think it does need to be a CTA- so it will show any impact to the carotid arteries, but I remember the tech saying it had to be sent off to be spliced for the 3D aspect. I had both an MRI and CT and was not diagnosed until the 3D CTA- I saw it and it showed such a clear picture of the right styloid hooked around my external carotid, and very easy to measure.

Thank you all. When I asked my ENT about the 3D scan she just told me they didn’t have that technology at the hospital she sent me to for the scan. Isn’t there a doctor that’s listed on this site that I can send a copy of the CT scan off to and he can maybe give me a better diagnoses?

Shanna W, where are you located?

post deleted by author

Shanna,

It looks like if you wanted to see a different ENT, these two doctors are on the doctor list that aren't too far away:

Dr. Chan, U of TX - Southwestern in Dallas 214-■■■■■■■■: http://www.utswmedicine.org/hospitals-clinics/aston/otolaryngology

Dr Richard Ragsdale - Presbyterian Hospital in Allen, TX 972-■■■■■■■■ http://www.texashealth.org/body_secure.cfm?id=2297&action=detail&ref=1406 (this doctor has done a successful Eagles Surgery)

Thank you for the information

This happened to me? My dentist found it on a scan in his office. But 2 weeks prior. I had a 3d Catscan with and without contrast. The radiologist’ did not say anything about Eagles Syndrome! After my dentist told me .I had it.So I called the imaging - center where the Catscan was done" And had the Radiologist* go back and Redictate- his findings! So he did and he measured the styloid growths" Basically’ if you get a bad radiologist like I did? They won’t notate this disease :frowning: But’ they have to go back and rewrite their findings if they missed something! Hope this helps!

Thank you, I will have to look into that.