I’m so sorry, I don’t know what to do w/ the images to see different aspects. I did use the scroll bar that shows up for the image on the lower right & could look at it from other angles which was helpful. The other 3 images are slices & I can’t help with those.
I’m removing your link because it contains the medical report that has your full name & personal contact information on it. My recommendation is for you to send your link in a private message to @LimeZest, @TheDude, or there are others on our forum who might know how to manipulate the images better than I do & can help you more.
You have a lot of calcification in your neck between the styloids & calcified ligaments which are very likely contributing to your symptoms if not the total cause. Calcified ligaments for some reason seem to be the cause of the crunchiness in the throat feeling even though they are lower down in the neck. Your styloids are more likely what’s causing the pain in the roof of your mouth.
Dr. Hepworth predominantly sees patients with vascular compression. They often go to him already diagnosed because it’s seen in scans they’ve had.
Dr. Hepworth wouldn’t use a lab that gives him inaccurate results so I’m curious what velocity chart & report discrepancies you saw in your case? Dr. Hepworth uses the blood flow velocities in the IJV ultrasound to help determine if a person might have vascular compression. If there isn’t already imaging that shows compression when the US indicates it’s a problem, then Dr. Hep sends the patient for more diagnostic testing such as an angio/venogram. The fact that he ordered an upright MRI for you indicates he’s concerned you may have CCI which is often a cause of IJV compression.
The dynamic CTA/CTV uses iodine contrast & takes about 30 min. Since an upright MRI is done w/o contrast, & is for the purpose of looking for CCI, I don’t know if it shows what’s happening to the vascular tissues when the cervical vertebrae are moving. Maybe another of our forum members knows the answer.
A CT of the neck is the same as a CT of the cervical spine. What you want is a head & neck CT with contrast if you’re looking for vascular compression. Have you gotten an updated one since you’ve been back in the U.S.? I know the U.S. doctors don’t want to see the scans you got in Peru. Just a CT with contrast would probably be fine to show what needs to be seen.
Fabi, since your symptoms are so bad, I think it would be a good idea for you to choose a doctor & have ES surgery to see which symptoms recover. After you’re healed, you can decide whether to pursue treatment for your remaining symptoms if there are any.
You’ve gotten opinions from a number of doctors but haven’t settled on one to see for surgery. Dr. Hackman would take out both styloids & stylohyoid ligaments at once which might be really helpful for you. If you haven’t had a consult with him, it would be worthwhile.
The two bones sticking straight out from your neck (below your calcified ligaments) could be the greater horns of your hyoid. I don’t see the rest of your hyoid bone at all which is odd.
