@loki - I’m sorry you’re dealing w/ FBS. It often goes away w/in 4-6 months but sometimes lasts a bit longer. The good news is that it gets less intense as time passes. I speak from experience. The thing that helped me most was drinking a lot of water/herb tea (not sweet or caffeinated drinks which can cause dehydration) i.e. 60-80+ oz/day so my saliva was super dilute.
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With time as @Isaiah_40_31 says it should fade, & you may well notice then which foods particularly affect it, sweet stuff made mine worse. I do still get twinges every now & then but it’s not intense…
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Thank you for posting. This gave me the confidence to make an appt with Dr Osborne today
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I have the same insurance and Dr C is not in network did you pay the $300 and then go from there?
Do you mean Dr. O?
It has been slowly improving, I’m still sensitive to sour and bitter foods like citrus, but I notice that dairy is often strong enough to irritate the salivary gland also, like plain yogurt or kefir – which is surprising because I never thought of these as particularly sour foods but I guess they’re a little sour.
Also, it’s much worse on my left side than my right side, as the left side was the more complicated surgery that took forever. My right side barely causes any pain in comparison, sometimes a little, so I’m often finding myself just chewing with one side as much as possible. Approaching the 3 week mark and swelling continues to subside. Still hurts to open my mouth, I have hypermobile ehlers danlos so I’m prone to subluxation of the jaw joint due to soft tissue laxity, so the swelling presses against the jaw and causes some jaw hypermobility. I’m sure it will hurt less as swelling reduces.
Anyone else here have ehlers danlos? I hear eagle syndrome is more common in ehlers danlos patients.
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This was in response to ICE, where they said they have BCBS of NJ and Dr. Constantino was not in network. But yes I have the same insurance and Dr. O is not covered either.
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I am taking Nervie- nerve health (Thiamin, B6, B12, Calcium and Alpha-lipoic Acid). I was doing really well and was taking it consistently, then got cocky and stopped lol. Had a flare up about 2 weeks ago where the teeth pain and shoulder pain really flared- sent me into a metal crisis. I think I over exaggerated myself. ( Helping my nephew with his goat and she kept tugging at arm and my whipping my neck ) This have improved but it definitely gave me that reality check that things are still very much not fully healed and I swore better compliance to the nerve vitamins.
ALF treatment is underway, its putting a lot of pressure on my TMJ and clicking while much improved is still painful. With each pop i feel it snap my trigeminal nerve. 
Chat GPT says this can take up to 1 year and is okay as long as its a steady improvement.
Also reading into something called “ Cranial- Cervical-Fascial influence” Something about the nervous system having to compensate for the muscle patterns stuck in place due to eagles and having to re-align. Considering neuromuscular rehab but honestly don’t have the energy.
Cranial-Cervical Fascial Influence After Eagle Syndrome
Eagle syndrome doesn’t just affect bones (the styloid) — it affects the entire fascial system that connects the skull, neck, jaw, throat, tongue, and even shoulder girdle.
When the styloid is elongated or the stylohyoid ligament is calcified, it creates chronic tension patterns in these fascial chains.
Even after surgery, these fascial patterns do not automatically unwind, so symptoms like jaw tightness, neck stiffness, dysphagia, facial pain, scapular dysfunction, and even tongue/taste disturbances can continue.
How to Fix Cranial-Cervical Fascial Dysfunction Post-Eagle
A. Fascial release work
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submandibular fascia release
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SCM + scalene decompression
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tongue and floor of mouth mobility
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suprahyoid/infrahyoid stretches
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TMJ capsule glide
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occipital/cranial base release
B. Neuromuscular re-education
To restore proper firing:
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serratus anterior activation
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lower trap strengthening
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deep neck flexor activation
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jaw relaxation training
C. Posture retraining
Correct forward head posture to reduce dural tension.
D. Gentle hyoid mobility
Helps relax the entire stylohyoid chain.
E. Breathing mechanics
Diaphragm + neck synergy reduces anterior neck fascial load.
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My first bite hit hard on my right side, also where Dr. O had a tougher time. Didn’t realize till a few weeks ago that the symptoms resolved. I am 5 months post op. Dr. O stressed avoiding anything citrus. Do your best to avoid anything that gets you salivating and hang in there. ( Kefir did it to me too lol! )
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Do you know if avoiding citrus and sour and bitter foods is recommended just because it’s painful, or if it’s recommended because it can actually damage the salivary gland while it’s healing? I forget what Dr. Osborne told me exactly, but from what I recall it seemed like he mostly stressed avoiding them because people found it unpleasant when the gland was irritated, and not because it would necessarily cause long term damage or impede healing?
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And for reference I’ve still been having a small amount of citrus or sour things, but fairly minimal, and it causes some pain and discomfort that subsides really quickly, otherwise salivary function seems totally normal afterwards.
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We have a large population of members who have hEDS on our forum. You’re in good company, @loki.
Avoiding citrus/sour/bitter foods is to help you be more comfortable & not because it can damge the salivary gland.
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Thanks for this info @vcp02 !
Maybe check out this info form @Emerald though given the supplements you’re taking:
Warning on Vitamin B6 supplmentation - General - Living with Eagle
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@vcp02 - I’m really sorry you’ve had such a significant return of trigeminal nerve pain but the article you’ve posted about Cranial-Cervical Fascial Influence after ES is really interesting & explains why some post op symptoms stick around for so long. Thank you for sharing some very insightful & helpful information. 
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I’m scheduled for bilateral styloidectomy with Dr. Osborne next week. I am more than ready to have these styloids removed, and I feel very confident that he is the surgeon meant to perform my surgery. I surprisingly don’t have any specific questions for him beforehand, nothing has crossed my mind, I fully trust that this is his terrain.
Since you recently had surgery with him, were there any questions you wished you had asked beforehand but didn’t? Or anything you were glad you clarified before your procedure?
I’d really appreciate any practical insight.
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I wouldn’t worry about it. I asked a lot of questions before, but I don’t think it changed anything about the way he did the surgery. Just make sure they’re aware of any allergies to medications you may have and any pre existing health conditions that might influence the surgery or anesthesia. He’s the best, he’ll do a great job. You’re in really good hands.
Just be prepared because the recovery can be slow and sometimes painful. The first bite syndrome can really get ya, and sour and bitter foods can really irritate the salivary gland. My surgery ended up being more complicated than most people, so the amount of swelling and pain I have has been worse as well, but it still hasn’t been too bad. The first couple weeks were tough. Try to rest and relax, be patient while your body heals.
Oh, and your throat can be very irritated for a few days after the intubation. My sleep apnea was a lot worse and it was hard to breathe even in the daytime, and I had trouble swallowing food and the pills they gave me. It’s from the intubation and it will go away, so try not to worry too much.
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I probably worded my question poorly, because I’m not worried about the surgery itself or the recovery. I am beyond ready, and completely confident in Dr. Osborne.
What I meant was more on the curiosity/clinical side. Sometimes after a consult you realize there was something interesting you could have asked but didn’t. For example, during my consult he showed me how long and thick my styloids are and how the veins are winding through them and they wing in. He mentioned stroke risk, and afterward I realized it would have been fascinating to see exactly what he was referring to onscreen rather than guessing later.
So I was asking more from that angle, whether there were any insightful or anatomy-related questions you wished you’d asked while you had him right there walking through the imaging. That’s the kind of thing I’m looking for.
But I really appreciate you sharing your experience, it is helpful to know what to anticipate during recovery.
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One thing you may want to ask, @MGORNEAU, is what position he has you in during surgery. In his videos patients appear to be supine, but you could ask if he ever deviates from that. I found out several years after my ES surgeries (by a different surgeon) that he turns his patients face down for ES surgeries & dislocates the jaw on the side he’s operating on so he has better access to the skull base. I was amused by this but also a bit dismayed because I have significant TMJ issues & had jaw joint pain for quite a while after my surgery & wondered why. In the end, the jaw dislocation has helped me as my TMJ problems are fairly advanced but now I’m totally pain free.
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I see. Hmm. I was mostly curious about trying to image my nerves to see if I could confirm nerve compression before jumping into a nearly 70k dollar surgery, after my CT w contrast showed jugular blockage. Interestingly, Osborne did not seem convinced that there was much of a reliable way to accurately image nerves. He said other doctors might disagree, but that was his thinking. I asked him about things like FIESTA or CISS MRI and he didn’t seem convinced these were very accurate or worthwhile.
I also was asking him about how early it is thought that eagle syndrome symptoms can onset, while it is unclear, he did mention that the youngest styloidectomy he had done was a 20 year old, so I suppose that implies at least teenagers can have symptoms, if not younger. Personally, I think i started having symptoms as early as 5th grade but it progressed over the years. Had the styloidectomies the week after my 36th birthday last month.
The funny thing about Osborne is it can be hard to get him to answer questions sometimes, not because he’s evasive, but because he’s honest. He won’t tell you something he doesn’t know for certain, which I respect. He’s a very down to earth guy.
I’m sure if you had very specific detailed questions about how the surgery is performed and all of that, he could probably tell you quite a bit!
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That’s really interesting. I’ve also wondered when this really began for me. I don’t think it started in childhood, but being hypermobile probably set the stage, connective tissue issues tend to create the “perfect storm” over time.
Did Dr. Osborne ever clarify your nerve questions after surgery? I have read that his signature approach gives him a very clear view to work from. My symptoms began with severe facial nerve pain and intense right-sided head pressure, and then the vascular component gradually layered on. I honestly don’t know which is more debilitating, nerve or vascular, it seems to depend on the day, both are miserable in their own ways. But I’m incredibly grateful to have found Dr. Osborne, because he’s giving me a real chance to stop just existing through each day and finally get my quality of life back.
Do you happen to know what position he puts patients in for surgery? Isaiah’s_40_31 brought up a good point about how positioning can explain a lot of post-op symptoms. My parotidectomy actually caused more neck pain from the positioning than from the surgery itself.
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