Evaluation Of Styloidectomy As An Alternative to Jugular Stenting

An Evaluation of Styloidectomy as an Adjunct or Alternative to Jugular Stenting in Idiopathic Intracranial Hypertension and Disturbances of Cranial Venous Outflow (nih.gov)
An earlier research paper by Mr Axon & Mr Higgins- an interesting mention that ‘What we are seeing here, however, is a variant in which the styloid process is not necessarily elongated but is orientated in such a way that its proximal segment impresses on the jugular vein.’ Useful for members with not particularly elongated styloids & reinforces what we’ve said on here that the angle can cause symptoms too.


@Jules A great research paper. I think a lot of folks deal with vascular surgeon before they meet ENT so the first procedure offered is stenting (my vascular surgeon did suggest it but I refused) without removing the compression since this is easy for vascular surgeons and only requires endovascular procedure to place the stent. This has HUGE failure rate and not only does the stent collapse under the bony compression of the Styloid & C1, but it is even harder to open the Jugular Vein after a rescue Styloidectomy as this study found. This has profound implication for those who are considering stenting without removal of the external compression. Not to mention the clotting risk that is associated with stenting in general. If anything, stenting can only be the last resort when all the other interventions fail including C1 resection.

Here is the gist of the study

A combined approach, of course, adds complexity to a problem that might be resolved by stenting alone but, in effect, is no more than a concession to the usual anatomy in this region in which the jugular vein has to pass through a relatively confined space between two bony structures—namely, the styloid process and the lateral mass of C1—likely to interfere with the proper functioning of a stent. Moreover, our experience of primary stenting in this situation is that stent dysfunction from external compression is difficult to resolve even when styloidectomy is performed subsequently (Table 4).

Thanks @Jules very good one.


I only found it from the paper you posted by Mr Axon :wink: