I wanted to provide a (likely final) update to my Eagle story. See above for more early detail. Too often the stories after surgery are those that have poor or mixed outcomes. It seems like those that have successful surgeries don’t come back to share and reassure.
tldr: Diagnosed in Sept 2017 by my ENT who has at this point, done the surgery three times (two extraoral, one intraoral). After researching, I decided to go with Dr. Samji, being one of the docs that has quite a lot of experience with the procedure and presentation. My left styloid was removed pretty close to the base. Surgery was outpatient and took about 60 to 90 minutes. I was off pain meds in about three days, released to fly home at one week. Chilled at home for another week, but felt fine to drive and do other, routine, non-work stuff. There was some swelling, that peaked at day 3-4. Scar closed well and was nicely approximated. I did start to form a more bulky keloid scar, so I’m now wearing the silicon scar treatment things to help flatten it out (I’m very pleased with the scar, but why not try to minimize it as much as possible). Week three to four: back at work and normal routine. I do have some numbness above the incision (an inch or so) and “first bite” symptoms on the side of the procedure, but its not a big thing to deal with and I’m sure it will improve.
Learnings:
- It’s not only about shortening the styloid. There are ligaments and structures that are attached along the length of the styloid that contribute to the sensations you are feeling. Addressing or “releasing” these during the procedure helps to resolve some of the “tightness,” pressure, and tension like pain.
- Intraoral is tempting and may work for some. However, the surgeon is essentially working in a hole. Understanding that there is more work to do than just breaking off the end of the styloid made the decision to go extraoral more clear. In fairness, I’m sure some surgeons have the intraoral approach down though. My other consideration was added recovery pain and increased chance of infection (your mouth can never be sterile and it takes about 48-72 hours for a wound to heal to the point that it’s considered “waterproof.”
Unexpected benefits:
- Sleeping better, probably due to less pain.
- Can now sleep on back, helped airway (NOT AN EXPECTED OUTCOME by me or the surgeon, but I’ll take it.
- Blood pressure dropped about 10 points into normal range. May be from less stress or pain, perhaps it was relief from a vascular symptom. idk…
- Seem to have less ringing in that ear.
- Feel less tired, especially in the mornings (may be from better sleep).
In retrospect, I had experienced symptoms for ~4 years to varying degrees. For about a year, I tried stretching and PT to determine whether I could minimize the symptoms. I came to the conclusion that I would eventually have surgery, so should face it head on.
I liked Samji’s demeanor and approach. My initial consult with him was over the phone. His medical assistant coordinated much of the pre work, including getting images and reports for him. He’s done the procedure well over 200 times and has good insights on the different ways the anatomy can present. He’s a pleasant, but factual guy and kept out conversation grounded. I felt well informed of the risks and felt like I was in control of the decision to proceed or not. He also has a clear and well established post surgical care plan that gives you a good perspective on what to expect.
Now I continue to be under the care of my normal ENT. It was a difficult conversation (for me), to let her know that another surgeon was going to perform the procedure. I set up an appointment for the week after surgery that served in continuity of my care and as a show of confidence in her ability to provide care in the long term.
Overall, scary experience, logistics (I travelled half way across the country for surgery), coordination, and time off work were a bit of a pain, but happy I did it, happy with the surgeon I chose, and the outcome. Still some healing to do, but quality of life is improved and it’s great to have the procedure in the rear view mirror! My other side isn’t as long or symptomatic. I’ll share if I need to go in for the second round 
So, As of 2019, I don’t really feel like I’m living with Eagle Syndrome anymore, I have better things to think about. Thanks for all the great information on the site! Being fair, there is some info that was less helpful/accurate, so for n00bs, be sure to research with a critical eye. Best of luck on your individual journeys. I hope my experience helps to return the favor for those that shared and helped me.