Dr Osborne agreed to Surgery

Ill have to wait and see the estimated cost since its paid in full upfront. He said my left styloid is one of the closest hes seen to the atlas. He agreed that the 1st radiology report was not correct in the length of the styloid. The left styloid would be cut leaving less than 1cm by external approach and he does use a nerve monitor. I asked about my right styloid and he said he operates one at a time and doesnt think the right should be removed if asymptomatic. Im a bit a confused because everything ive seen on this forum says to get both taken out. If anyone has insight what i should do as far getting both taken out or not it would be greatly appreciated. Here is a report from my 2nd radiologist.

Two things - 1) It isn’t uncommon for the shorter styloid to be the more problematic styloid. My right one was shorter & though the left was causing more pain, the right was causing more vagus issues like crazy heart rate, blood pressure & breathing issues when I exercised. My surgeon opted to remove the right first though I asked to have the left one out because of the pain it caused. In the end, I think his decision was the best.

  1. It isn’t necessary to have both styloids removed in bilateral cases. We have some members who felt fine after having one side taken care of. We also have members who had the second one removed even though it was asymptomatic, & post op began struggling w/ pain they didn’t have previously. It’s best to err on the side of caution w/ this surgery. Only get the second styloid removed if it’s causing symptoms that are seriously impacting your life, otherwise don’t touch it i.e. “If it ain’t broke, don’t fix it.” I’m so glad Dr. Osborne also takes this stand.

That’s good news that Dr Osborne has agreed to do the surgery! I hope you don’t have to wait too long!
As for the 2nd side, I’d wait & see how you are after surgery & everything’s healed- sometimes the other side does seem to get worse once the first side is removed, whether the worst side masks pain or whether everything in the neck shifts a bit after surgery who knows! But maybe that’s why you’ve got the impression both should be removed? As @Isaiah_40_31 says there are risks to the surgery, so it’s not to be undertaken lightly, just have to see how things are after a few months.
Let us know when you get a date for surgery!

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Is less than 1 cm ok? Or should I look for a surgeon that will remove to the skull base

Less than 1 cm should be fine since you don’t have vascular symptoms. We’ve recently found that some of the surgeons who say they remove the styloid to skull base do leave a stub behind.

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