I’m diagnosed with elongated styloid process of 42mm and 30mm on left…i’m feeling dizzy,brain fog,vertigo and lack of concentration.Is this symtom of eagle or i have any other health issue like C1,C2 INSTABILITY
All these can be symptoms of vascular ES yes, I’ll post a link to the list of common symptoms:
ES Information: Common Symptoms And Possible Explanations For Them - Welcome / Newbies Guide to Eagle Syndrome - Living with Eagle
Probably more likely to be internal jugular vein compression (IJV), but dizziness can happen with carotid artery irritation too, and feeling faint can happen with that.
A CT scan with contrast would show IJV compression, are you able to get that done?
I don’t know too much about CCI, but one of our members has posted info about a quick way to see if you might have it:
Can anybody help me to confirm if my CT shows elongated styloids? - Welcome / New User Help - Living with Eagle
An upright MRI with head flexion & rotation can show CCI I believe, or a DMX (digital motion x-ray) , again I’d don’t know if you’re able to get either of those done?
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I forgot to say that if you do have IJV compression, then sleeping propped up in bed a bit can help with the build up of head pressure, some members have taken blood thinners which can help with symptoms, but it would be best for you to get diagnosed first.
@Ruslan posted about a supplement he’s finding helpful:
Eagle syndrome with IJV Compression.New member from Russia - General / Eagle Syndrome Stories - Living with Eagle
And @mekanX posted this:
Brain fog and creatine - Symptoms and Treatments - Living with Eagle
Check with your doctor though before taking supplements, especially if you’re on any medication.
This discussion might be helpful:
CranioCervical Instability (CCI) and head tilting - General - Living with Eagle
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Thank u for your reply my constrast ct of neck angiography venogram is normal according to doctor but styloid are abnormally enlarged 42 and 30mm.
Like dizziness is not all the time more in night…and in dark place
@madhavshrma Have you had any vestibular testing? An increase in dizziness when it’s dark is a good sign that your vestibular functioning may be off and could improve with vestibular rehab.
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Thank u for replying,I don’t think so..because i don’t have any kind of ear problem
That possibly doesn’t sound as if it’s vascular ES then, it would be most of the time for IJV compression. The vestibulocochlear nerve I believe can be affected by ES so it could be it’s causing you dizziness, as @Chrickychricky suggests it might be a vestibular malfunction! If you search for vestibular rehab exercises online, there are some simple ways to improve it, might be worth a try…
Looking at your scans- and this is not a medical professional opinion, I could be wrong!- quite a few of them aren’t to the skull base so it’s not possible to see the styloids very well… & I can label them for you, so will do my best to point out a few possible things to ask your doctor about:
Your hyoid bone process in some of the images looks very close to the carotid artery bulb, so possibly with head movements it could irritate the blood vessels, which can cause heart arrythmias or possibly feeling faint or dizzy.
The styloid looks visible in the bottom left image, but not in the image above it…It looks like you have an elongated styloid process one side, but the other side has a section of calcified stylo-hyoid ligament.
I can only see one image which shows your veins; to me it looks like the right side is possibly flattened a bit by the C1 process, but that could just be the view of the CT, I can’t see much of the vein on the left side, so it could be a non-dominant vein and naturally smaller.
Your hyoid doesn’t look fused but that could be your age…
It doesn’t look like you have much of the normal curve to your neck, which is called military neck- we’ve had lots of discussions about that on here, it can sometimes make ES symptoms worse & there are exercises which you can do to help , here’s a link to a long post @vdm did:
List of my favourite resources on YouTube to learn anatomy - General - Living with Eagle
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@madhavshrma - I took out your images because your name & birthdate were on many of them. It would have taken me too long to black those out. I reposted the images I felt were the most significant & have annotated them for you. Once you’ve removed your personal information from the images I deleted, you can repost them.
I agree with everything @Jules has said in her post to you. Here’s my analysis of the images I put back into your post (I’m not a doctor so this is a lay person’s opinion):
The top picture shows both your left & right sides & you can see how your hyoid bone appears to have a joint between the body of the hyoid & its greater horns (see annotation on picture 3 below).
In the second picture, I’ve circled two areas on your C1 vertebra that show bony outgrowths which are not normal. These may be of no consequence, but they could also be problematic, if not now, then maybe later.
As stated above, your hyoid bone appears to be jointed. This isn’t terribly abnormal as there can be variations in the way hyoid bones appear & is most likely not a problem by itself, however, as @Jules noted, the left greater horn of your hyoid does appear to be poking your internal carotid artery right at the carotid bifurcation (the place where the common carotid splits into the internal & external carotids) & the carotid bulb which is just above the bifurcation. (See picture 4).
Your left styloid is very thick & your right one appears long & thin. Both have physical attributes that could be contributing to your ES symptoms. As @Jules also noted, your cervical spine is quite straight so doing some gentle exercises suggested in the post she sent you could help restore the curve & possibly lessen your symptoms to some degree.
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Yeah i’m telling many doctors from too long my hyoid bone is making strange noises during swallowing but they say u are mad…So do u mean i have elongated stylohyoid ligament that connects to hyoid bone…can u please elaborate my problem in detail so that i can tell it to doctor directly and refer image number if possible Thank you u know much much better than doctors.
True…in mri report of cervical spine there is loss of cervical lordosis given…but what causing main problem is it hyoid bone or something else…what ligament surgery will helpful for me can u pls tell me…pls mention my problem directly as i’m not from medical field in simple term
Greater horn is not fused to hyoid is it due to trauma…i went for an ultrasound she did my ultrasound very bad…like put intense pressure with probe of ultrasound on my whole neck…only after that i got symptoms of eagle syndrome…and story of neck problems begin…is it possible that her ultrasound caused eagle and greater horn problem because ik that ultrasound procedure was not less than a trauma.
These are most likely symptoms of ES & not CCI (instability) but I am not a doctor so am only giving my personal opinion.
I annotated the top picture now to show you the greater horns of the hyoid on each side. Your stylohyoid ligament is NOT calcified all the way to your hyoid bone so that is not your problem.
If you look at the 3rd image that I sent last night, you can see the left greater horn of your hyoid appears to be poking into your carotid artery at the bifurcation (the point where it splits). That is most likely what is causing your dizziness & some of the other symptoms. If you have pain in your face, neck, shoulders, ears, or other areas in your upper body, that is most likely being caused by your elongated styloids.
You mentioned dizziness, brain fog, vertigo, & lack of concentration. Do you have tinnitus (ringing in your ears) or pulsatile tinnitus (hearing your heartbeat in your ear)?
If the angio/venogram was done w/ your head in only one position, the problem may not have been obvious. An angio/venogram looking for compression of arteries &/or veins needs to be done w/ the head being turned in different directions during the procedure.
The symptoms you have can be caused by the carotid artery being irritated by your hyoid bone or styloids. There are nerves in the artery in the carotid bulb (labeled in image 4 above) which react to pressure being placed on them so the symptoms you have can come from the left greater horn of your hyoid poking the internal carotid artery in that area.
Vestibular problems aren’t always caused by the ears. They can be caused by the brain, too.
When the internal carotid artery is being irritated or compressed by the greater horn(s) of the hyoid bone or styloids, it slows the rate freshly oxygenated blood into your brain which can cause the symptoms you have.
When the internal jugular vein is compressed by the styloid (& sometimes the C1 vertebra contributes) then deoxygenated blood can’t flow out of your brain as fast as the fresh blood flows in from the carotids so pressure builds up inside your brain which is called intracranial hypertension. As you can see if either the internal jugular vein or internal carotid artery is being squeezed to a smaller size, it will affect how your brain functions & can cause the symptoms you have.
I think the calcified stylohyoid ligament that @Jules mentioned is part of the whole right styloid which is longer than the left as you know.
In the image that shows your jugular veins your right one is dominant as @Jules noted, however, it doesn’t look compressed to me in the image as the width of it is fairly uniform down its length. You also don’t appear to have collateral veins which are extra veins the body makes to help blood flow out of your brain when the IJV(s) are compressed.
I would say it’s your hyoid bone that is causing your worst symptoms & your styloids are possibly contributing to nerve pain symptoms if you have them.
The pressure from the ultrasound probe would not have caused any of the problems you have. They existed before you had the ultrasound, but the pressure from the probe may have caused a bit of inflammation which caused the symptoms to flare up & become more obvious. to you.
As I mentioned, having a “jointed hyoid” isn’t abnormal. It’s just one of the variations of how the hyoid can look. It generally is an insignificant finding.
You can print the images I’ve marked & take them to your doctor to show the observations that I have made & ask questions based on what they show. If your ENT doctor or whomever you’re seeing for ES isn’t helping you, you could try seeing a vascular surgeon to discuss the pictures where the greater horn of your hyoid appears to be poking your carotid on the left & discuss that the left IJV (internal jugular vein) isn’t visible & ask if that is significant. Getting the left & possibly right greater horns of your hyoid shortened might help resolve your worst symptoms, but your styloids, especially the right one, may also need to be cut back to get the best overall results.
Lastly, you asked if we can turn your images into 3D. We can’t do that because we’d need the original images. If you can get them on a disc (CD) or uploaded to your computer via soft copy, you can convert them on your computer using RadiAnt - radiantviewer.com or by uploading them into dicomlibrary.com. If you aren’t able to do that, maybe a family member or friend can help you.
Please let me know if there is anything you don’t understand in what I’ve written.
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So may be i need surgery of greater horn of hyoid bone…because there is no pain in my neck means styloid in not causing any problem…i feel only strange noises of hyoid bone during swallowing of saliva like clicking,rubbing sound.Yeah i will go to radiology department ask for cd..is recession of greater horn a major surgery will my voice change or ut give me big scar ?Do u think that C1 vertebra causing any problem?
No i don’t have any kind of pain rarely mild pain like negligible pain on lower jaws…also no tinnitus.Only brain fog ,unable to focus,Doctor told me you have symptoms of CCI AND AAI…but whenever i fold towel and keep under my back of neck while sleeping i don’t feel clicking sound of hyoid bone…I get little elevation in my cervical spine
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Yes, you possibly need surgery to shorten the greater horn of your hyoid bone. It’s good the styloids don’t seem to be causing any symptoms. The other things you just mentioned - clicking, rubbing sound of hyoid are more symptoms of Hyoid Bone Syndrome or Clicking Larynx Syndrome than ES.
Yes, resection of your greater horn is a major surgery like the surgery for ES is. It shouldn’t change your voice or give you a big scar if you see a surgeon who is experienced w/ the surgery.
I’m sorry I can’t tell if your C1 vertebra is causing any problems. It has the bony outgrowths I mentioned, but they may not be contributing to your symptoms. I’d say don’t worry about them now. Get your hyoid bone taken care of first. It will take a number of months after the surgery before the symptoms it is causing go away, but that is normal. Healing is gradual. @a_catindisguise is one of our members who had hyoid bone surgery, & she wrote a lot about her recovery on our forum. You could read what she wrote so you know what to expect, but keep in mind we each heal differently & at different rates, so you may have a different post op story than she did. Her diagnosis was clicking larynx syndrome, but that is somewhat the same as Hyoid Bone Syndrome.
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Ok…but i’m from India i have to research alot to find a doctor who can deal with hyoid bone problems…Till now i was unable to find…An ent doctor refered me to a neurosurgeon…ent doctor said he is neurotologic.
How can i share you my CD whenever i will get because you are far more knowledgeable than doctors here…through email?
I’m sorry our information regarding doctors in India are very limited. Perhaps the neurosurgeon can refer you to someone when you see him. If you can travel outside of your country for surgery, there are doctors in the US who do hyoid bone surgery. I don’t know of any in other countries except possibly Dr. Aghayev in Turkey. Several of our members from India have gone to him for ES surgery & IJV decompression & have mostly had good results, but I don’t know for sure that he does hyoid surgeries.
•Dr. Kamran Aghayev - https://kamranaghayev.com