Here’s a video from removing styloid by Dr Bargiel from Poland.
The styloid process was removed in just a 5 minutes 
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Interesting! Although usually the benefit of having an external styloidectomy is that the surgeon has better visibility of the blood vessels & nerves, this way looks quite blind…no nerve monitoring by the looks of it?
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It’s an interesting video, @mist. Thank you for posting it.
I agree w/ @Jules, it’s bit scary that Dr. Bargiel felt where the styloid was then put his clippers in the incision & “blindly” cut the styloid off. The video also doesn’t show if Dr. Bargiel smoothed off the cut tip of the styloid inside. If it’s left rough, that can continue to cause problems. The video cut off after the styloid was removed so perhaps he did that extra step. In the end, if his patients are getting good outcomes from his ES surgeries then his technique is working well for him.
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Here’s some information I was able to get
It is crucial to orient the forceps’ tips medially during this maneuver to diminish the risk of damaging the facial nerve and potential rupture of the IJV. If the styloid process exceeds thickness of 5 mm, it is advisable to employ forceps from both sides instead of attempting to fracture it.
To ensure that no sharp edges remain, the base of the skull is palpated. Any residual fragments can be easily removed with straight Pean or wire-twisting forceps.
Thank you for sending this information @mist. I’m glad Dr. Bargiel checks for sharp edges after styloid removal & before closing the incision. It’s also good to know he’s careful about the facial nerve, has a plan for an extra thick styloid & is careful to remove fragments. It’s impressive that he’s able to do all this by feel rather than by seeing the styloid, nerves & what’s left behind after most of the styloid is removed. Every doctor seems to have their own approach to ES surgery. Good technique usually provides good patient results.
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