Dr. Cognetti or Annino. A coin toss?

Over the past month I have had appointments with 3 of the doctors in the group of, most discussed and highly regarded, on this site. There was not much difference between them regarding procedure or expected outcomes. I did narrow it down to Dr. Cognetti or Dr. Annino. I would like to hear what experiences those have had who underwent the surgery with either of them. With something as serious as ES surgery I would hate to make my final decision based on a coin toss.
Thanks in advance for your input.

Hi Fred,

Though I didn’t have surgery w/ either doctor (Dr Samji did mine), I do know that Dr Cognetti leaves an inch of the styloid behind rather than cutting it back to the skull base. There have also been mixed reports about whether or not he removes the stylohyoid ligaments if calcified. I don’t know how short Dr. Annino cuts the styloids (back to skull base is best) or if he removes calcified s-h ligaments.

Some of our members have had the styloids regrow when they are not completely removed thus knowing each doctors’ surgical strategy may help you make your decision.

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I’m guessing that you’ve maybe searched the discussions for info on the doctors?
If not, then here’s one about Dr Annino:
Surgery Is Complete! Dr. Annino is Amazing! - General - Living with Eagle
& this one mentions how much of the styloid & ligaments were removed:
Brain fog and fatigue - General - Living with Eagle
We do have lots of members who have had successful surgeries with Dr Cognetti, but as Isaiah says, Dr Cognetti does leave a little of the styloid process & if your stylo-hyoid ligaments are calcified too then you would need to clarify with him if he intends to remove them as these could still cause symptoms otherwise.
I guess also to take into consideration is waiting times, especially in this current time of uncertainty, & how easy it is for you to get to either hospital.

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Dr. Annino also said he would not remove the entire styloid. He said the further you go up into the skull the more chance of complications as everything gets “tight” in that space. Dr. Cognetti said he would leave a “stump” of the styloid. Currently surgical times would be mid-Jan with Annino and beginning Feb with Cognetti. Really like both of them, and they are obviously both highly regarded. I am thinking of seeing Hackman only because of the robotic option. I’m 2 hours to Annino and 4 to Cognetti.

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We’ve had a few members who’ve seen Dr Hackman recently- not sure what the conditions are for robotics, but I don’t think some of the recent surgeries have been done with robotics.

Hi Fred01,

Jules is correct regarding our members who’ve recently had surgery w/ Dr. Hackman. He makes the call as to whether he’ll do intraoral (robotic) ES surgery or external surgery although, he may offer either option in some cases. You can schedule a phone consult with him to ask him directly about his philosophy & approach to ES. He does do bilateral surgery in one surgery as opposed to two as many other doctors require. Dr. Cognetti & maybe Annino are among those who require two surgeries in bilateral cases. Dr. Hackman’s schedule is more like Dr. Annino’s than Dr. Cognetti’s. & Dr. Hackman does remove the styloids back to the skull base if possible.

I had my left side done with Dr Cognetti last October he is also a plastic Surgeon so the scar isn’t very noticeable it was a little sore for awhile and some numbness in the chin and lower lip, it’s feeling good now and I have been waiting to get the right side done until covid is under control I live in Tennessee and have to travel and stay in a hotel for a few days and I don’t want to take a chance of getting sick.

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Thanks for that update. I’m still trying to decide who to use. Both excellent surgeons. For me, Annino is 2 hours closer.

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