I am scheduled to have surgery in May. I am worried about the greater auricular nerve being cut. I don’t understand why they have to do that and not just move the nerve out of the way.
Did you end up having surgery with Dr. Costantino?
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I messaged you directly because I’m dumb and didn’t realize this was a comment on a post ha!
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@mfinch27 - You’re absolutely not dumb. This site is not straightforward to use, however, if you’re communicating via PM, there is a little gray envelope icon in the upper left to the right of the butterfly icon. The envelope isn’t present in a public forum discussion.
Example:
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Thank you 
In this case I might’ve been a little dumb haha all I had to do was expand my email to see it had been a comment to a post via a private message but you are right this site is definitely not straightforward to use. Appreciate the help!
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Hi @IJVHelp. I just wanted to let you know that I had surgery last June with Dr. C & he & Dr. Tobias did cut my greater auricular nerve. It was pretty annoying having a numb outer ear for a while until I got more used to it. They sew it back together , but it takes time for the nerve to heal. I have noticed improvements, but still have some slight numbness on the outer ear and along the jaw but it continues to improve. It is not painful at all. Nerves can take quite a while to heal. I believe that he said that they cut the GAN for better access. He also does nerve monitoring during the surgery. I am not sure why they cannot move it out of the way, but I do know that he moved other nerves and structures during my surgery. I don’t see why they would cut anything unless they felt it was necessary to improve the outcome of the surgery. If you find out anything regarding that, please let me know. I may have to have surgery on the other side & am interested to find out anything that can help the surgery be done in the best possible way. I hope that you get the answers to put your mind at ease about the surgery.
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I received your message, and it was greatly appreciated. Don’t worry, I am still learning to navigate this forum. It’s all a learning experience.
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Hello, I will talk to Dr. Costantino and Dr. Tobias next month and update you on the result of the surgery. I would think they must have a good reason to cut the GAN so I suspect they will explain it to me then.
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Thanks for that info @vap , good to know that the nerve is still healing…as far as I’m aware I didn’t have the nerve cut during my surgery (I’m UK), but I do still have a little numbness around the same area & weird sensations sometimes, so at a guess maybe it had to be stretched quite a bit out the way.
Good to hear the nerve can heal after being cut, I wouldn’t have thought it would be able to!
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I agree and do remember that prior to surgery we discussed the fact that they were planning to cut the GAN and that they would repair it . They approached it as a standard part of the procedure and did not foresee any permanent impairment from it. However, they did say that it would take a while to heal. I look forward to hearing what you find out at your appointment next month. It’s funny how much we learn through this process…I didn’t even remember anything from biology/anatomy about the styloid bone prior to being diagnosed with Eagle Syndrome, now I even know what the GAN is. I’m sure everyone who has gone through this diagnosis and surgery has learned more than they ever wanted to about all of the sensitive structures in that area. 
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Thanks @Jules! The nerve cut leaves a definitely different sensation on the cheek, jaw, & ear area. It didn’t hurt as much as it felt so very strange not having any sensation. It was very interesting though that although the whole outer edge of the ear was numb, I had normal feeling everywhere else. Yes, I’m thankful that it is healing even though it is taking a while. I’m guessing that I will possibly have some residual effects, but even if it doesn’t improve more, it is something I can live with now. Glad that you only have a little numbness now. It’s amazing how such nerve damage can heal. My husband had brain surgery many years ago which left the whole side of his fact fairly paralyzed. His nerves didn’t show much healing until about 18 months after the surgery and then they just kept healing. It is actually difficult to even tell now that he had such nerve damage. I’m so thankful that the Lord designed our bodies to heal this way.
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Amen to that @vap!
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That’s interesting that your hubby’s nerves took even longer than we usually think of to heal! You two have obviously had your share, God bless 
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I don’t want to unnecessarily worry you but I wish someone has told me this before having surgery with Dr. Constantino and Dr. Tobias… I did really like them but I had my surgery on December 18th, 2023 and I’m still having a lot of nerve pain. Initially my earlobe was just numb but now it really hurts when I touch it and I can feel the numbness and pain down my ear and jawline. The incision site also still hurts. I can feel it constantly. Dr. C said everything was fine afterwards but it doesn’t feel that way to me. I also continued to have headaches after the surgery, which was my worst symptom, so it was a really frustrating experience.
I spoke with Dr. Hepworth and he went over my surgical notes and said there was no reason they should have cut any nerves. He also said they didn’t address the area of my IJV that had the most compression, and he told me that he’s repaired a number of surgeries done by Dr. C. My sinus issues weren’t addressed either. I’m now seeing Dr. Hepworth this June to repair my previous surgery and fix my sinuses and I wish I’d just seen him to begin with. I’m not sure if Dr. C is your only option but if he’s not then I personally wouldn’t see him again or recommend him to anyone.
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I’m sorry that your surgery outcome wasn’t what you’d expected/hoped @Melodious21. I’m also glad that Dr. Hepworth is willing to help you & will do a revision decompression surgery & take care of your sinus problems, too. I have seen him & have great respect for his knowledge & surgical techniques.
I must tell you, though, that one of our members who saw Dr. Hepworth for VES surgery recently had revision surgery by Dr. Costantino w/ a better outcome than she had w/ Dr. Hepworth. Dr. Nakaji has also done a few revisions for VES which were done by other surgeons and didn’t turn out well. I believe no doctor is perfect & no patient has the exact same response to ES &/or vascular decompression surgeries. There is a reason that medicine is referred to as “a practice”. Just as in any activity we choose, practicing helps us become more proficient, & with each surgery a doctor does, his/her skill becomes more honed, however, mistakes can be made, & physical responses can vary which makes a surgeon’s task especially challenging when it comes to trying to help repair a complex situation.
I hope your upcoming surgery makes a HUGE difference in how you’re feeling.
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Hi Melody, I agree with Isaiah regarding the unfortunate side effects of your surgery with Dr. Costantino. I did a lot of research, and I think my main issue is brain fog and Dr. Costantino has a good track record for relieving this symptom. I agree that the nerve being cut makes me nervous, but I can live with some numbness if it resolves my brain fog. Does it feel like your pain and numbness are improving at all or is it just the same since surgery?
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Definitely, I am still researching and learning for my pre-op appointment. Do you think Dr. Costantino would address C2-C3 compression that came up during my venogram with Dr. Fargen? I am trying to see if Dr. Costantino would do a fasciotomy on my jugular around C2-C3 to relieve the compression.
At first my earlobe was numb and I didn’t mind, but as time went on and the nerve began to regenerate, it because painful. If I touch my ear I feel a sharp pain down my entire jaw. It constantly feels like my skin has been pulled back really tight and I feel numbness still but also a tingling, sharp pain. There hasn’t been any improvement and it’s been 16 months since my surgery. None of my symptoms improved with the surgery either, including brain fog. It wasn’t until Dr. Hepworth put me on an anti blood clotting medication (Xarelto) that the headaches improved for me. I should also say though, I’m a complicated case. I have Ehlers Danlos and CCI, and generally don’t heal easily and always seem to have the worst outcomes from surgeries. Dr. Constantino also found that my veins and nerves were half the size they should be. He said I have the vascular anatomy of a 12 year old, so that is another contributing factor to my compression and blood flow issues. I also have similar compression on the other side so I may need to do the other side to get symptom relief. I was just surprised when Dr. Hep said that the nerve severing was unnecessary. He also said the area of the most compression based on my jugular vein flow velocity test wasn’t addressed during my surgery with Dr. C, who did tell me I could have compression higher but that he didn’t feel comfortable going any higher than he did. My experience at the hospital in Stamford was excellent though and I do really like Dr. C and Dr. Tobias. I agree that it’s a complicated surgery and they’re still learning. I’m just hopeful that Dr. Hep will be able to repair things. He did say in regards to the nerve pain I’m still feeing that it may be compressed so I’m hoping he may be able to do something about it. I hope your surgery goes as smoothly as possible! I realize not everyone has the same outcomes with this kind of surgery. Dr. C made it sound like most people just get a numb earlobe so maybe my experience isn’t that common.
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Oh, the joy of being a ‘difficult case’ @Melodious21 , I’m so sorry that the first surgery didn’t help, but glad that you have Dr Hepworth on board now to hopefully improve things…sending you a hug & prayers for getting fixed! 
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Thank you for clarifying your situation with Drs. C & Tobias, @Melodious21. I am very sorry, too, that your first go around w/ ES surgery/IJV decompression wasn’t successful & has left you with a new problem. I also hope Dr. Hepworth is able to take care of anything Dr. C missed or wasn’t comfortable dealing with & that if your nerve is compressed or tangled up, he’s able to free it. Just be aware that any working with the nerve during surgery, even to help it, can cause the symptoms from that nerve to be worse initially after surgery, & it can take many months for the nerve to heal. Worse nerve symptoms won’t necessarily happen, but I need you to be aware that it can, so you’re not caught off guard post op if you’re more uncomfy rather than less.
I’ll also pray for you to have a great outcome from your surgery w/ Dr. Hepworth.
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I’ll keep you in my prayers with Dr. Hepworth. Hopefully he can relieve your nerve pain. Thanks for sharing your experience.
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