X-rays don’t provide anything better than the CT unfortunately. But I think we know what’s likely causing your symptoms at this point - calcified stylohyoid ligament, hyoid greater horns, and/or thyroid superior horns
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Your thyroid looks odd to me, too, @mjzago, but I don’t know enough about thyroid anatomy to be able to say whether it’s outside of normal or not.
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I’m sorry that you’re having a bad day… I hope that it settles down quickly, take care 
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Today I was on the Ludwigshafen Klinikum and had a talk within the maxillofacial surgeon. She said my stiloydes are on a grey zone. About 3,0cm each side. They offered me a surgery to remove both process and also my both wisdom teeth of the right side. One surgery full of risks because of the proximity of my wisdom teeth with the nerve. I’m still waiting the the diagnosis from Dr. Martini.
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On Ludwigshafen I have the chance to do the surgery from inside the mouth. I can also do the stiloydes first and then the wisdom teeth.
That’s a tricky one, as intra-oral surgery is usually a tougher recovery, and also there’s more risk of infection and not as much of the styloid can be removed…
If you’re able to put up with the symptoms for now, it’s worth trying to get opinions on your hyoid bone as well; did you get the chance to ask about that?
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I didn’t manage to ask the doctor about the hyoid bone. She was very kind, but I was so nervous and in pain that I couldn’t really speak up when she mentioned that she could do the surgery. I want to wait for Dr. Martini’s and see which approach he deals.
My symptoms are still the same: neck pain, facial pain, pain around the eyes, and blurred vision in my left eye. I’ve had a few days without pain (right now no pain on the hyoid area), but most days the pain is present. Do you know what kind of medication is usually recommended? At the moment I’m on amitriptyline and gabapentin, but I’m not sure they’re helping. I think I need to ask the doctor again and maybe try a muscle relaxant, anti-inflammatory, or a painkiller.
The nerve pain medications can take a few weeks to build up enough for them to work, other ones which some members have tried are carbamazepine, pregabalin, lyrica, memantine for example. Muscle relaxants like baclofen or flexerin. Steroids can occasionally be prescribed in a short course, or otherwise as an injection with lidocaine into the tonsil region, you could ask Dr Martini or the doctor you saw today about that… here’s a link to some more info:
ES Information- Treatment: Pain Relief And Medications - Welcome / Newbies Guide to Eagle Syndrome - Living with Eagle
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Hello everyone,
I wanted to share an update on my situation. So far, I haven’t been able to get in touch with any doctors here in Germany regarding my Eagle Syndrome diagnosis.
In the meantime, I managed to schedule a teleconsultation with Dr. Irlon Oliveira in Curitiba, Brazil. He is very experienced and has specialized in Eagle Syndrome. During our consultation, he recommended that I undergo a 3D CT Angiography of the cervical region and head.
Since I am currently in Germany, I plan to have this scan done here. Depending on how long it takes to get proper medical attention locally, I might consider having surgery with Dr. Oliveira in Brazil.
For anyone looking for a fast and expert diagnosis, I can highly recommend him.
Contact information:
Dr. Irlon Oliveira
Eco Medical Center
R. Goiás, 70 - Água Verde, Curitiba - PR, 80620-060
Hospital Nossa Senhora das Graças
R. Profa. Rosa Saporski, 229 - Mercês, Curitiba - PR, 80810-120
+55 41 98201531 (WhatsApp from the secretary)
I’m sorry that you’ve not been able to see anyone in Germany so far, but thank you for giving us the info about Dr Oliveira, I’ve added that to the doctors list! Did you ask about costs of surgery there?
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I didn’t ask about the cost of the surgery yet, but I’ll have a follow-up with him soon and can ask about it then.
The consultation fee was R$500, which is around €100 (more or less).
He also sent me the diagnosis and exam request in three languages — Portuguese, English, and German.
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It sounds like you’ve found a good resource in Dr. Oliveira, @mjzago. Did you discuss your hyoid bone w/ him as that’s potentially a big contributor to your symptoms?
I hope you don’t need to travel that far, but if you do, I hope he is very helpful for you.
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Yes, I mentioned my hyoid bone and the greater horn during the consultation. Dr. Oliveira said it’s important to do the 3D cervical angiography first to get a better overall assessment before drawing any conclusions.
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Hi everyone,
I currently have two referrals for consultations with Dr. Blake and Dr. Martini in Germany. I’m hoping that by December I’ll be able to decide whether or not to go ahead with a styloidectomy.
I’m also waiting to have an angiography that was prescribed by Dr. Oliveira, to get a better picture of my vascular situation before making any decisions.
I’d like to ask if anyone knows whether Dr. Blake or Dr. Martini also perform removal of the greater horn of the hyoid bone, or if they have any experience addressing that area during surgery.
One thing that consistently helps to ease my symptoms is gently pulling or massaging around the hyoid area — similar to what’s shown in this video:
https://youtu.be/Bjt168bJS7g?si=svP5uuB3Xbfhi3Wo
Thank you very much for any information or experiences you can share.
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If you dont have a traditional osteopath already, I strongly encourage you to find one to help manage the symptoms w gentle osteopathic manipulations(there are several gentle treatments)
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@mjzago - It’s great that neck movements like were shown in the video help ease your symptoms. I assume you’re not doing those w/ the extreme head flexion that the therapist does w/ his patient when he brings him upright & leans him forward. I would expect those to worsen symptoms caused by the styloids.
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I couldn’t watch that, it made my neck hurt just the first few seconds, I felt sick 
Good if you’ve found something to help you though!
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I still haven’t received any response from the doctors here in Germany — neither from Dr. Martini nor from Dr. Blake. I have an appointment with Dr. Blake on December 5th.
In the meantime, I contacted a radiologist in Brazil who reviewed the CT scan I had done. I’ll also be doing another radiological exam with contrast soon.
My radiologist found some issues with the hyoid bone and is also ruling out Eagle’s syndrome. Please see the photos and the results below.
HEAD AND NECK RADIOLOGY
SECOND OPINION ON MAGNETIC RESONANCE IMAGING OF THE NECK
Date of exam: 06/17/2025
Gender: Male | Age: 37 years old
Second opinion date: 11/09/2025.
Requesting physician: NOT INFORMED
Clinical indication: evaluation of neck pain.
TECHNIQUE:
Standard DICOM images of Magnetic Resonance Imaging were received on high-field equipment, with acquisition before and after contrast administration.
Acquisition quality analysis: images of satisfactory quality.
DESCRIPTION:.
Slight thickening and sclerosis of the bone marrow of the upper right horn of the thyroid cartilage, better characterized on the CT scan of 07/29/2025, Figures 1 and 2), associated with thickening of the adjacent soft tissues without diffusion restriction and with increased post-contrast enhancement (Figure 3), causing a small mass effect on adjacent structures, notably on the posterior and lateral walls of the piriform sinus and on the prevertebral muscle, and associated with slight contrast-enhanced enhancement of the right piriform sinus mucosa. The corresponding cartilaginous marrow shows hyposignal in all weightings, consistent with sclerosis, confirmed on CT scan dated 07/29/2025 (partially available exam).
There are no signs of elongation of the styloid process-stylohyoid ligament complex
to characterize Ealge syndrome. Dental metal material generating artifacts on the structures of the oral cavity, which
show no obvious changes.
Other aspects of the neck without changes.
Absence of cervical lymphadenopathy.
.A summary analysis of the brain shows no changes, making it impossible to assess the possibility of neurovascular conflict in the sequences available. Shows sclerosis of the bone marrow of the right upper horn of the thyroid cartilage.
DIAGNOSTIC IMPRESSION:
Inflammatory/infectious changes near the right upper horn of the thyroid cartilage (right upper horn syndrome?).
We did think your thyroid cartilage looked a bit abnormal, but he’s not said much about the hyoid? I guess you could do some research yourself and see if there are any doctors doing surgery on the thyroid in Germany while you wait for your appointment with Dr Blake? Frustrating that you’ve not heard from Dr Martini…
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I agree that it’s frustrating & surprising that you haven’t heard back from Dr. Martini’s office. It may be time for you to start calling them periodically until they give you an appointment. Sometimes we have to self advocate by being “squeaky wheels”. In the US the saying goes, “a squeaky wheel gets the grease.” ie keeping after his office may help you get an appointment vs being ignored.
In the pictures you sent, the thyroid cartilage looks to be more of a problem than the hyoid, & since that was the radiologists focus, maybe it’s the bigger problem. As @TML noted you have pockets of calcified stylohyoid ligament in your neck & these could also be causing problems even though your styloids aren’t elongated. It’s too bad the radiologist didn’t mention them in his report, but it’s something you could bring up when you have your consult w/ Dr. Blake, & hopefully eventually w/ Dr. Martini to see what they think about those as well as the thyroid cartilage & hyoid greater horns.
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