I have been diagnosed with Eagle Syndrome last summer. I had a styloidectomy with Dr. Osborne on my right side in Oct 2025 but still have not had any relief of symptoms. They got worse actually and I have new post-surgery symptoms. He cancelled my left side surgery because the right side was really difficult to get out.
I now know that my left jugular is compressed by my styloid, even if all my symptoms are on my right side. My right transverse sinus is also fully occluded (likely congenital).
So I know I need to get the left out and likely have my jugular decompressed.
Considering my surgery with Dr. Osborne has not yet been successful in relieving my symptoms, I’m considering other surgeons. I have a consult with Dr. Cognetti in April.
Does anyone know if Dr. Cognetti removes the entire styloid (at least enough to get rid of symptoms)?
Surgery for left side with Dr. Osborne is not off the table - just looking for my best option. I don’t want to need more surgery after this one.
Welcome to our forum. I’m glad you found us & hope we can give you the support you need.
Dr. Cognetti is actually a better choice for a vascular ES surgery as he works together with a neurosurgeon, Dr. Heller during those surgeries. Dr. Heller is there to shave C1 if it’s necessary to make more space for your IJV to open up. Dr. Osborne doesn’t do anything beyond styloidectomies so if the compression is caused solely by the styloid(s) then vascular symptoms usually resolve after a surgery Dr. Osborne has done, but if C1 is contributing, there’s a good chance symptoms will continue.
Dr. Cognetti cuts the styloid back to 1 cm or less which is very short. He’s been on our Doctors List for more than 11 years & has helped a huge number of our members over that time. He is a good option for your next styloidectomy especially considering the accompanying IJV compression.
Dr Osborne has done lots of successful surgeries and does remove the styloid back close to skull base, which is usually enough to improve symptoms- Sometimes even the most experienced surgeons have to leave a little nub of styloid as it can be too close to nerves & too risky to remove higher…
As well as Dr Cognetti, Dr Nakaji in AZ, Dr Hepworth in CO, & Dr Costantino in NY all doe vascular surgeries & C1 shaves if needed to decompress the IJVs, if you wanted to get any more opinions, although there can be long waiting times!
Hi Steve,
It’s great that you are continuing to seek help in this journey. It’s definitely not black and white.
I’m curious to know what new symptoms you got after your styloidectomy in October? What are your symptoms now from the jugular vein compression?