I have bilateral ES & had a 7cm styloidectomy on 11-26-25. I’m still having symptoms & the ENT said, even if styloids our removed you can always have the ES, just wondering if this is correct? TIA
@tree.1317 - Welcome to our forum! I’m sorry you were diagnosed w/ ES & a 7 cm styloid is HUMONGOUS! I’m glad your surgery is behind you. Your doctor is not correct. If enough of your styloid was removed, you should experience decent reduction or recovery from your symptoms, but it will take time.
Did you only have one elongated styloid or is your other one also long?
Do you mind sharing who did your surgery?
Do you know how much styloid was left behind? What symptoms are still bothering you?
Was your surgery done intraorally (through your throat) or transcervically (through your neck)?
You’re about 2 mos post op from your surgery which by all considerations, especially for a styloid that was so long, is still sort of early in recovery. ES symptoms are usually caused by irritation to cranial nerves that “live” in the neck or exit the skull in the area where the styloids are. When these nerves are irritated, it can take quite a number of months, even up to a year or more, for them to fully recover once the styloid (or other source of irritation) is removed. If your other styloid is also elongated, it may be that you’ll need to have that one removed as well, in order to get the best long term results.
Symptoms can come & go during your recovery & can be easy to overdo physical activity on days when you feel good which will flare symptoms again. We highly recommend starting back into physical activities (housework, yard work, fitness) by baby steps not leaps & bounds.
You can try using heat on your neck at this point, & lidocaine patches have been helpful for some people in relieving nerve pain. You can start stimulating nerve healing by using a very soft cloth or even a feather to gently stroke any areas that are numb, tingly, burning, etc, as that will help promote nerve healing.
Hi Isaiah,
My sugery was done from the outside of my neck. I honestly don’t know if he was able to remove all of it or not. I just know that the ride side is 7cm too. The Dr said I’m not well enough to have the ride side removed.
I have left sided facial numbers, which I had prior to my surgery, headaches, on my left & right side, I’m very dizzy which wasn’t an issue prior to my surgery & I’m very forgetful
I think I answered all of your questions. Thank you for replying to my post
@tree.1317 - Having another styloid that is 7 cm isn’t helping anything! Symptoms can cross over from one side to the other once one styloid is removed i.e. your remaining styloid can be causing symptoms on the opposite side.
Dizziness & headaches are often due to vascular compression being caused by the styloid. They can be from the internal jugular vein being squashed between the styloid process & C1 vertebra. I’m wondering if you have IJV compression which was undiagnosed prior to your styloidectomy & the surgery has made the symptoms worse.
Who did your surgery?
Numbness is normal after surgery & can take quite a number of months to resolve, however, dizziness is not typical which leads me to be concerned about the vascular compression component. I had that, & the surgeon who did my original 2 styloidectomies missed it so I had to have a third surgery 10 years later to get it fixed. It took 6 years before I knew to look for it & another 4 years to get it officially diagnosed & dealt with. Would you be able to upload any of your CT images on the forum for us to look at? Now that I’m better informed, I know the surgeons on our Doctors List who specifically do ES surgeries along with IJV decompressions.
The carotid artery is another vessel that can be compressed by the styloids but it usually opens up once the styloid is gone. The IJV can remain compressed if C1 is also contributing to it’s stenosis as sometimes C1 needs to be shaved a bit once the styloid is out so there is enough space for the IJV to reopen.
I’m very sorry you’re not recovering well & hope we can help unravel the mystery of the onset of your post op dizziness.
I so appreciate you responding to me. I don’t actually have a way to upload the images of my CT scan Dr Waxman did my surgery. He did say the remaining styloid wasn’t pressing on my jugular vein. Is that the IJV? I truly appreciate you responding to me. I’ve not been able to work & I really thought this surgery would help. The last time I saw the Dr he said I didn’t show enough improvement for the 2nd surgery & to follow up with a neurologist.
I’m so sorry you had to struggle with ES for so many years.
Thank you again for responding to me
I’m sorry that you’ve not had an improvement since your surgery, that’s rough…
I agree with @Isaiah_40_31 that it is still early days in your recovery and we have seen often on here that nerves take a long time to heal, & some members have come back a year after their surgery to say that things have improved… We have also seen members who have symptoms cross over from one side to another, and often members don’t see much of an improvement until both sides are done. Unfortunately many doctors don’t believe that this can happen, and like you’ve found, they don’t then want to do the second side as they don’t think it’ll help!
It’s not a bad idea to have an appointment with a Neuro- if you’ve not tried nerve pain meds before then they might be worth trying while you decide next steps? I also think if you can get a CT scan with contrast it would be worth doing to look at whether you do have any vascular compression (the IJV that Isaiah mentioned is the Internal Jugular Vein). Dizziness is often a common symptom of vascular compression, but it could possibly be an irritated vestibulocochlear nerve, or maybe even the vagus nerve. Do you have any head positions which trigger it particularly? Some members with dizziness have tried vestibular rehab to help, there are exercises on YouTube which can help, might also be worth a try?
If you do get a scan, then you could decide whether it’s worth getting side 2 done, or if you still have quite a bit of styloid on the surgery side left then this could be a culprit. Sending you a hug 
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@tree.1317 I agree with @Isaiah_40_31 and @Jules, getting a CTV to look for possible IJV compression (on both sides) would be a good next step.
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Thank you for everyobe for your responses, All of you have provided me more information & guidance then I’ve been able to obtain 
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We’re here for you, @tree.1317. I’m glad we’ve been able to help you some already!