Doctors Cognetti and Hackman

I went to a follow up appointment with Dr. Hackman today. Someone had told me that Cognetti trained Hackman and I thought that was weird because they are about the same age.
I asked Dr. Hackman about it and he said that Cognetti was one year ahead of him in medical school. Dr. Hackman was the chief resident and Cognetti was a fellow at the time they got trained by the same Dr. He said they are very good friends.
I asked him how many surgeries Cognetti and himself had done and he said Cognetti had done 35 and him about the same. He also said that Cognetti was also trained on the Davinci Robot. I don’t know if he does as much robotic surgery though. I haven’t heard anyone of this site say he has but who knows.
Dr. Hackman said they pretty much had the exact same degrees and specialties except that Hackman also does reconstructive surgery and Cognetti doesn’t.
Dr. Hackman had a lot of good things to say about Cognetti. I thought it was interesting that their experience and degrees were almost totally aligned. Just thought everyone would like to know . It’s hard to figure out how experienced a Dr is. I am thankful and I am sure many are to get this information so they can make the best choice for themselves. I hope others will read about the Davinci Robot. It is much less invasive and a quicker recovery (but some cases can not be done with the robot). I spoke with my sons friend from college who is a Head neck surgeon and he told me that was the way to go if you can. He hoped to get trained on it. He is in Brazil and he said right now they just grab the styloid and snap it out and don’t remove the process. I told him I glad I didn’t have you and of course he laughed. Just thought this might be some good information so everyone can read as much as possible to make the best choice for themselves. So many are under the impression that you can’t do it intra orally and get everything out but you absolutely can if you are a candidate for using the robot. I hope this helps some patients to make sure they research and choose what is best for them. I also spoke with a patient who went to an osteopath and got a lot of relief. She had been to many doctors and was pretty surprised. I am sure that probably wouldn’t work for every case but it would be worth it to some to investigate. Thanks.


Thanks for the info about the doctors, & robotic surgery. It’s interesting to know about their training, & robotic surgery sounds really promising! Although I don’t agree with the numbers- Dr Cognetti has been doing surgeries as long as I can remember from info on here & that’s 6 years, so I would think he’s done more than 35.
We’re careful though not to suggest that anyone sees a chiropractor or osteopath, as if they’re not experienced & knowledgeable about ES they could cause serious harm. I know of one member who’s avoided surgery for a while by this, but care is needed.

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Dr Hackman spoke with Cognetti last week. That’s what he told him. The numbers are probably lower than you thought because Eagles is so rare.
I did not digest a chiropractor as they are not an MD. I don’t know if you know but an Osteopath is an MD. They are very well educated. so I don’t think you have anymore chance of harm than going to any MD.

August 21

Thanks for the info about the doctors, & robotic surgery. It’s interesting to know about their training, & robotic surgery sounds really promising! Although I don’t agree with the numbers- Dr Cognetti has been doing surgeries as long as I can remember from info on here & that’s 6 years, so I would think he’s done more than 35.
We’re careful though not to suggest that anyone sees a chiropractor or osteopath, as if they’re not experienced & knowledgeable about ES they could cause serious harm. I know of one member who’s avoided surgery for a while by this, but care is needed.

Cognetti was only one year earlier in Med school so that’s pretty close in experience.

I feel confident about the numbers or I would not of posted them. I got my information straight from an MD not guessing.They are very good friends and talk a lot. like I said in the post. Hackman had nothing but good things to say about Cognetti.

Also I didn’t know that Cognetti doesn’t take out ligaments but I didn’t post that because I don’t know if it is on all patients. Hackman has done two revisions from Cognetti surgeries recently, I have no idea how many revision surgeries Hackman has had, I did not ask him. probably all doctors have some things that have to be redone at some point. I found out about the revisions from the patients.

I don’t think it is fair to suggest that Cognetti and Samji are the most experienced. I didn’t ask about Samji experience. I think to say that they have a lot of experience is fine and informative. Hackman has very similar experience. Except Hackman is also trained in reconstructive surgery. And he has done more robotic surgeries. I did say in my post that it was good for everyone to get all the information they can so they can research and get as much information as they can to make the best choice for themselves. You will never see me try to guess on a members post about there condition as I am not a doctor. I do see many members do that which Is really not appropriate as they have no medical degree like I don’t. To tell them about there experience is fine.

Look up an osteopath in a lot if cases they are more trained than most MD,s and I know the one in the groups osteopath was. She researched Visited Cognetti and Hackman got a consult and decided to go with an osteopath first. She is medically trained. She is a nurse practitioner. I believe I said this probably isn’t for everyone. I am sure an osteopath can not help everyone but I feel sure they will not hurt them. They are heavily trained,I totally agree on what you said about a chiropractor. You haven’t seen me post that nor will since they are not an MD.
I think you all do a great job of keeping good information out there and thank you for all your time in volunteering to do so.
I just wanted you to know I didn’t put out any information that would ever hurt anyone. All I did was give them accurate information empower them
Wit more knowledge so they can make the right choice for themselves.

Have a great day!

Sorry about the typo’s. I didn’t have my glasses on. It changed some words that I obviously didn’t hit the keys right. I see digest instead of suggest etc.

I’m UK; we have a different system here, osteopath’s do alot of training, but aren’t doctors, so didn’t realise that it’s different in the US! Thanks!

That’s interesting they are an MD specialist with more training here. Good to know.



Dr. Samji has done over 500 ES surgeries. I believe that’s more than most other doctors in the US. Dr. Milligan in Phoenix has done 300-400. There are doctors on our forum who are a bit more experienced w/ ES than others. We try to let our members know who they are in case that matters to them.

Also, you can edit your post by clicking on the … at the bottom of the post. A tool bar will appear. Click on the pencil icon & an editing window will open where you can make corrections & changes.


I absolutely believe that everyone should get as much information as possible so they can be empowered by information to make the correct decision for themselves.I never said or implied otherwise. But the information needs to be accurate or close. I believe that Samji is probably one of the most experienced, although I do not know. I am basing it on the patients on the group. Where are you getting your number of Eagles surgeries done by doctors? I am very curious… When I see a lot of discrepancies I have to find out what is right. It is in my nature because I don’t want to be misleading people. On February 4, 2014 you posted that Samji had done over 400 surgeries. Then Jayde on June 14, 2014 posted that she had spoken with Samji and he told her he had done 50-60 surgeries. I do not believe he could have possibly done 350 to 360 Eagle surgeries in 4 months time. That is why I would like to know where you are getting your figures. I honestly can’t say he has or hasn’t but i do intend to find out. Even 50-60 in 2014 probably would be more than most any surgeon. Remember how rare Eagles is. There are not a large amount of people going for Eagles surgeries.
I personally asked Dr. Hackman this week at my followup because of discrepancies I had heard about his training and Cognetti because I was told Cognetti trained him which was not true. They were in training together. They were trained by the same Doctor’s/program (although Cognetti was a year ahead of Hackman in medical school. They are very good friends. Dr. Hackman had nothing but good things to say about him. I am sure both are very good Doctor’s. I asked how many Eagle Surgeries Cognetti has done and he told me 35 that he had spoken to him about this last week. He said he had done about the same. He said in training and surgeries they were pretty similar. Although he did not give me a number. I didn’t question that. I had no reason to. I did find it interesting that Hackman told me Cognetti is also trained in robotics. I haven’t heard from anyone in this group that has had that done by him. I have no idea if he is doing this or he doesn’t have the team you need to do robotics etc.

I would like to know where (if there is a website, etc) you are getting your numbers? A friend of my son is also a head neck surgeon in Brazil and he’s only had two cases come to him in 4 years. I know people fly to the best etc but if this isn’t coming from a factual place I would try to use the numbers that the Dr. Himself is telling the patients. According to my son’s friend, 30 or more would be a very experienced doctor in Styloid and ligament removal.

I agree that some are more experienced. Also some doctors believe totally different things about Eagles. Some doctors are trained in newer less invasive (if they are a candidate for those techniques). That is why it is important to empower this site with as much accurate information as possible and not diagnose them ( as most members on this site are not doctors or medically trained) but let them have the information to make the best choice for themselves.

I appreciate all the work you and the volunteers do. The more accurate information or more patient’s personal experiences you can get out there is extremely helpful to members to make the right choice for them.

Thank you in advance for empowering me with the information of where to find out the number of Eagles surgeries a doctor has done. Have a great evening!

Can you please send me the link to my post from 2/2014? I wasn’t on this forum until 10/2014 as I wasn’t diagnosed until the end of Sept. that year. Dr. Samji had done about 75 surgeries at the time he did mine in 11/2014. The current number I posted came from Dr. Samji himself about a month ago. The info about Dr. Milligan came from one of our members for whom he did ES surgery about a year ago.

The most reliable source for the number of ES surgery any given doctor has done is to ask the doctor himself. I only quote what I hear from our members after they’ve had an appt w/ a given doctor & learned the information from the doctor during the visit. I do a fair bit of private messaging of members here so these numbers aren’t always posted in a public thread.

I do agree w/ you that accurate information is vital on this forum. Our goal is to give the most up to date & correct support possible.

I hope this helps.;_ylt=A0geKeo1YkBfRBMA_oBXNyoA;_ylc=X1MDMjc2NjY3OQRfcgMyBGZyA21jYWZlZQRmcjIDc2ItdG9wBGdwcmlkAzNVNG5XUDVjU3plRTcxU0sxUjh3OUEEbl9yc2x0AzAEbl9zdWdnAzAEb3JpZ2luA3NlYXJjaC55YWhvby5jb20EcG9zAzAEcHFzdHIDBHBxc3RybAMwBHFzdHJsAzQ4BHF1ZXJ5A3dobyUyMGhhcyUyMGRvbmUlMjB0aGUlMjBtb3N0JTIwRWFnbGVzJTIwc3luZHJvbWUlMjAlMjBzdXJnZXJpZXMEdF9zdG1wAzE1OTgwNTQ5OTY-?p=who+has+done+the+most+Eagles+syndrome++surgeries&fr2=sb-top&fr=mcafee&type=E210US91088G91207

okay I was trying to send you a picture of the conversation because on screen when you go to this link it says 2014 to the right of the conversation but when I printed it (as my iphone is in the middle of a download so I couldn’t send the picture) It says 2020. But when you click on the link you will see why I thought 2014. That most be when the thread started or something. Sorry about that. again either way I thought he was one of the most. I am going to see if I can email some of these doctors and get stats as I know Cognettis amount of surgeries was much higher than he supposedly actually has done. But again I was told by a head neck surgeon anything about 30 would be very experienced. was much different than Cognetti and Hackman were at about 35.

I’ll send you the picture tomorrow so you can see why I thought that. I don’t want to sound difficult but if that was the fact that was very hard to believe. And obviously since I went to print and the full date came up it was February 2020. But that is the link so you can see. And I had seen a little bit of miss quoted figures. Again sorry for that. In no way or shape or form did I want to make you look bad. I just am very inquisitive when I see something that doesn’t make sense. I have to get to the bottom of it. It’s how my mind works.

Thank you for correcting me! I will try to find out if I can get updates on how many surgeries several of these doctors have done to date if possible.
That helped a lot! Have a great weekend!


Thank you, adriene61, for your reply. I understand how that kind of mistake could be made as the date by a post only shows month & day not year.

I hope you’re able to get a response from the doctors you email. I do agree w/ Jules that Dr. Cognetti has done more than 35 ES surgeries since he’s been doing close to 1/month for at least the last 6 years. That alone adds up to close to 72 ES surgeries. Please let us know what you find out if you get responses. That would be very helpful info for our members.

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When I saw Dr. Samji in early Feb 2020, he told me personally (and a witness) he was at 450+. Although not exact, I understand 20% of his practice is ES, the rest of his practice is related to cancer of the neck, and other ENT diagnosis. Given he does ES surgery weekly, I have no doubt he is probably over 500 at this point in time. I chose him over a local doctor who said he had “assisted” in 50 and didn’t like me challenging his views about ES. Ive had bad outcomes after surgery because of allowing “green” doctors operate on me. Like many here, we have gone years and countless docs to finally get a ES diagnosis. Not all of us have a choice to go to the most experienced and by many patients accounts Samji has a pretty decent bed-side manner. I did and I am thankful I have that choice.
As for Cognetti’s #'s, I would trust the number that comes out of his mouth, not another doctor as information can change when it is passed through people and easily misinterpreted.
I have seen many osteopaths in my life including my current neurologist who after years of seeing other docs, diagnosed my ES. Like many docs, there are good ones and bad ones and it depends on their specialty, focus and training. Another I recently saw who claims do to “craniosacral” work and also incorporates acupuncture as well as hocks products I found to be a bit of a kook. She scared the begeezus out of me when she told me my daughters jaw was way out of whack as well as her teeth after years of retainers, braces and expanders. In a panic, I contacted an orthodontist and incurred all kinds of bills for demanding 3-D modeling be done of her jaw to find that everything was in its place.
As for Davinci robot, I was evaluated for hysterectomony, bladder suspension and pelvic floor reconstruction. I specifically sought out a doc who had extensive experience using it. Extensive to me is in the 100’s and where my comfort level lies. Just because a person has an MD after their name and taken a couple weekend trainings on any surgical tool or new procedure, doesn’t make me comfortable allowing them to cut on me. My understanding is that it is best suited for certain internal surgeries. I’m not so sure ES would fit what I understood it is best used for. In my case, the doc said my surgery could all be done vaginally which would be a better and faster recovery. Having had abdominal surgery before, any incision in stomach requires gas pumped in to inflate the area for the instruments. The side effects of that gas after surgery can be very unpleasant. Bottom line is my surgery did not require Da Vinci Robot. For internal ES surgery, I’m not sure that would have any impact because it is so close to mouth. I suspect it has no value for external ES surgery.


I absolutely agree. I’m not telling anyone who is best, worse, etc. All doctors are different and seem to have different thoughts, approaches etc. I believe in my last post I said based on what I’ve heard from the group Samji is one of the most experienced (just guessing based on patients reviews, I am not a doctor or medically trained and just going by what I hear from patients experiences). My surgeon would have no reason to lie to me. He has a lot of experience, specialties and awards. Not saying any others don’t, I haven’t looked. The doctor I mentioned was not Samji. I questioned the numbers some are giving because of hearing different things. My doctor trained with the doctor I mentioned and he said that was the number he told him. Personally as long as they are experienced and have a great record and beside manner that is all I care about. It’s an added bonus to me if they have extra degrees like vascular if they are going to be working around nerves and vessels. The Davinci Robot has everything to do with an Eagles surgery if they are going to take the styloids and ligaments out, if you are even a candidate for it. The styloids are very easy to get to (I met one doctor that just grabs the end and snaps it). I wouldn’t go to that doctor personally. The robot can follow the styloids and get it all. It is a less invasive surgery. That’s not coming from me that is coming from medical journals. I would normally agree that extensive would be in the 100’s. I was quoting only Eagles surgery. Many more surgeries types of surgeries have been done on the robot and done without it. Removing the styloids and ligaments is only a small part of most head and neck surgeons. My surgeons does have a lot more surgeries using a robot than I quoted but I only was speaking of Eagle’s Surgery. I got the number that 30 would be pretty experience from a head neck surgeon that is a friend of my son in another country. As you know there are not that many cases of Eagles Syndrome. It’s under a 200k being a rare disease. A lot more than the numbers go into a choosing a physician or surgeon. Ratings on a surgeon, how many areas trained in, If they have new techniques your interested in etc. I could go on and on.

I haven’t said one time to go to a certain doctor or not. As a matter of fact most if not all of them mentioned on the site have great reputations. I was only repeating right out of a doctors mouth that has is very experienced,many awards, specialties and training. But since I did hear different numbers on one doctor it makes me curious to try to find out if possible( factual ) numbers.

You quoted what your doctor said. I know mine said he talked to him last week so it didn’t come out of his mouth, but I have no more reason to think my doctor would lie than yours. As far as the osteopath goes. I didn’t go to one. I was just repeating a patient’s experience ( who is medically trained themselves had). Even said I’m sure it’s not right for everyone.

As I have said before and will always say to anyone going through this. Empower yourself with knowledge, so they can make the right choices for themselves. Research and read all you can about it. Everyone doesn’t fit into one box.

Even the best most experience doctor’s can make mistakes or not be able to diagnosis everything etc. There definitely are good and bad doctors. That’s why everyone has their on brain to empower themselves with as much knowledge as they can to make what they think is the right choice for themselves.

I don’t think the robot would be used for external but since you brought it up I will ask.

Have a great day!

Interesting about the robot with intraoral. I wasnt able to find alot of data on it specifically with ES but did find some. The red flag I saw was that insurance isn’t inclined to approve its use due to the cost re: its more expensive than traditional surgery. Unfortunately that slows alot of progress. I already have been fighting with my insurance on a more non-invasive GERD surgery. We fought it all the way up the appeals process and they will not budge. Would luv if you can post any peer-reviewed studies or data on ES and Da Vinci outcomes.
I know alot of numbers get thrown around here and alot gets lost in translation sometimes when information moves from one person to the next. I totally get having a doc that is board certified in vascular surgery as a plus and any other add on experience. I had a bone surgeon/ortho sever a nerve during surgery. This was early in my life and I was not so experienced. I sure wish I had a neurosurgeon on that team! Live and learn. Always best to do your due diligence when considering any surgery.

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I’ll try to find out of Nord’s or my doctor if that is possible with the privacy laws. But I would think you could since you wouldn’t know names. I’ll also find a good article on it to post.
Thanks and have a great day!

So you know if Dr.Cognetti performs angioplasty (ballooong) after styloids are out and before stitching you up to make sure the vein is open and blood is flowing?

As far as I know, no one has had that done by Dr. Cognetti. It would be worthwhile asking him (if you have a consult w/ him) if he ever works w/ a vascular surgeon in case IJV angioplasty is necessary after a styloidectomy.

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I actually have a consult with him on August 10th :+1:


That’s brilliant news, others have found him really helpful, let us know how you get on!

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