Do you have a tight ligament in your throat?

Hi everyone,

I’m still trying to get to the root of my issues and have an important question. There is this pain condition called “Superior Pharnygeal Constrictor Muscle Dysfunction” discovered by doctor Ernest, who also discovered Ernest Syndrome (=hyperextension of the stylomandibular ligament). It is often overlooked and/or misdiagnosed as Eagle or Ernest Syndrome.

Basically, there is a ligament in the jaw called Ptyergomandibular Raphe that is prone to tendinitis after trauma. It results in permanent nerve irritation of the two attaching muscles (Buccinator and Superior Pharyngeal Constrictor Muscle), mimicking pain arising from Eagle and Ernest Syndrome.


My pain is mostly on the right side. This is where this ligament is pretty prominent in my jaw and it hurts if I touch it. It is just super tense, really, especially if I open my jaw. It feels like it’s permanently sore, whereas on my left side I can’t even properly feel it. I suffered neck trauma four years ago; two years ago I had a chronic cough and this is when I developed almost all typical Eagle symptoms, starting with a constant painful globus sensation, jaw, temple and neck pain.

My question is: Can you feel this ligament on the side that is most painful to you? More than on the other side? The ligament/raphe starts right behind the wisdom teeth and ends below your back teeth (see photo).

Here’s the literature on this condition:

Anterior Throat Pain Syndromes Causes for Undiagnosed Craniofacial Pain.pdf (8.6 MB)

I’d be glad if you could check this and give me a short reply.


Hi Michael,

Since my ES surgery, I have issues w/ First Bite Syndrome & some residual nerve pain on the right side of my face. I also have significant TMJ & a bit of jaw muscle atrophy on the right (muscle atrophy caused by ES surgery nerve damage). It sounds worse than it is, but I see a cranial chiropractor a couple of times a month. He works the exact area of my mouth on both sides that your picture shows. It’s very painful when he “strokes” the tendons (raphes), but I usually have no pain once he’s done. This process helps my jaw stay aligned better as the right side pops partially out of joint periodically when things aren’t lined up. He also uses a cold laser over the nerve damaged area which has reduced my FBS symptoms & helps reduce the nerve pain.

This doesn’t exactly answer your question but is related.

My ligaments feel really tight & are quite prominent, but not painful. An interesting article though. I’ve read up a bit on Ernest Syndrome & there have been a couple of members who’ve been diagnosed with Ernest instead of Eagles, but to me it sounds really hard to distinguish between the two- before surgery I had pain in both areas suggestive of Ernest & ES! I guess after trauma there’s probably all sorts of muscles & tendons affected & tendonitis is perhaps common.
Might be worth looking into for yourself?

Hello Michael,
I will be having my surgery a week from Monday. I have a very tight ligament to the point I can hardly open my mouth. My ligament has become so calcified that the calcification is larger than my new bone.


good luck! Are you talking about your pterygomandibular ligament being calcified or your stylohyoid ligament?

Anyways, I hope surgery will resolve your pain!

Styloid ligament. My doctor at the clinic told me I had the largest calcified ligment they have ever seen. I am very nervous about the surgery hoping and praying everything goes well. Thanks for wishing me well. I was glad to find out it was eagle syndrome. Ive had lots of Black out that have been unexplainable. The doctors thought they were Panic attacks.