# External surgery question!
**URL:** https://forum.livingwitheagle.org/t/external-surgery-question/642
**Category:** General
**Created:** [December 28, 2014, 1:54pm UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642 "2014-12-28T13:54:09Z")
**Posts on this page:** 18
**Page:** 1
### Author:  [@tiagito78](https://forum.livingwitheagle.org/u/tiagito78)
#### Post date: [December 28, 2014, 1:54pm UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/1 "2014-12-28T13:54:09Z")
I am currently waiting to have my right styloid removed by extraoral/external approach and would like to know how the surgeon could possibly remove the bit of the styloid which is protruding behind my tonsil with this approach ?
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### Author:  [@Isaiah\_40\_31](https://forum.livingwitheagle.org/u/Isaiah_40_31)
#### Post date: [December 28, 2014, 5:32pm UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/2 "2014-12-28T17:32:15Z")
The external approach allows the surgeon full access to the neck & behind the throat areas. My left styloid which hasn't been removed yet is poking me in the throat as well. I'm hoping to have it removed in May. My right one which has been removed was poking farther down my esophagus. I think most people w/ advanced ES (i.e. the styloids have grown down to or close to the hyoid bone) have some protrusion into their throats & the external approach has been successful in allowing the surgeons access to both the stylohyoid ligament & the extended styloid process for removal.
I hope this is helpful.
Isaiah 40:31
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### Author:  [@Isaiah\_40\_31](https://forum.livingwitheagle.org/u/Isaiah_40_31)
#### Post date: [December 28, 2014, 5:41pm UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/3 "2014-12-28T17:41:51Z")
Just found this in another discussion on this forum:
_National Journal of Otorhinolaryngology and Head & Neck Surgery, Vol. 1(10) No. 3, December 2013_
_Conclusion_
_External trans-cervical approach is better procedure than_
_intra-oral approach in excising the elongated styloid process_
_because of better exposure, less operative time, less blood_
_loss, cost effective, can be operated in high risk patients and_
_greater length of styloid process can be removed._
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### Author:  [@tiagito78](https://forum.livingwitheagle.org/u/tiagito78)
#### Post date: [December 28, 2014, 8:42pm UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/4 "2014-12-28T20:42:13Z")
yes I understand that but what I mean is , the styloid is protruding behind my tonsil therefore when the surgeon removes the styloid there will be hole left where the tip of the styloid was protruding ! does he stitch the hole or what ?
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### Author:  [@Brazilian](https://forum.livingwitheagle.org/u/Brazilian)
#### Post date: [December 29, 2014, 12:51am UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/5 "2014-12-29T00:51:04Z")
I did this external surgery on both sides and I will try to comment on the little I have learned. There, an inch below the ear, there are several bundles of muscles and nerves. They are cut with care and apart laterally to find the calcified ligament styloid behind these structures. The periosteal tissue surrounding the calcified styloid is cut lengthwise. Bone is unglued this periosteal tissue. Once the bone is cut and removed, the periosteal tissue is sutured to the ligament retrace.
The muscles and nerves back to normal position and receiving some absorbable suture. Finally the skin is approximated with a line of suture to be removed one week after surgery.
Remember that there will be a small drain arrested the incision. Before leaving the hospital the drain will be removed. Generally this surgery is not painful recovery or compromise the movements and swallowing.
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### Author:  [@tiagito78](https://forum.livingwitheagle.org/u/tiagito78)
#### Post date: [December 29, 2014, 12:24pm UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/6 "2014-12-29T12:24:07Z")
thanks for your input [Brazilian](http://forum.livingwitheagle.org/forum/topic/listForContributor?user=1qqcb5791y8wl) ! were any of your styloids protruding into your tonsil fossa like mine is ?
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### Author:  [@Mayela](https://forum.livingwitheagle.org/u/Mayela)
#### Post date: [December 29, 2014, 6:21pm UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/7 "2014-12-29T18:21:24Z")
One of mine was protuding to my tonsil. I had surgery on both sides and there is no sign afterwards of any visible diference between them. The only thing I experienced was more internal pain (and tonsil soreness) on the side where it was protuding compared to the other one. However, not even on that side the pain was unbearable. It is someth8ng that goes away in two or three days. You will be absolutely fine.
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### Author:  [@Brazilian](https://forum.livingwitheagle.org/u/Brazilian)
#### Post date: [December 30, 2014, 2:54am UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/8 "2014-12-30T02:54:34Z")
Yes. I could touch the tips of styloids with the middle finger. Introducing finger between the base of the tongue and throat I felt the bone. Over time I stopped doing that because shooting a lot of pain. Believe me, the improvement was fantastic after I removed those nasty bones.
tiagito78 said:
> thanks for your input [Brazilian](http://forum.livingwitheagle.org/forum/topic/listForContributor?user=1qqcb5791y8wl) ! were any of your styloids protruding into your tonsil fossa like mine is ?
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### Author:  [@Lisa](https://forum.livingwitheagle.org/u/Lisa)
#### Post date: [December 30, 2014, 3:18am UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/9 "2014-12-30T03:18:01Z")
Good question. My right one is poking my tonsil too.
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### Author:  [@Lisa](https://forum.livingwitheagle.org/u/Lisa)
#### Post date: [December 30, 2014, 3:20am UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/10 "2014-12-30T03:20:27Z")
Do these grow back after we have them removed?
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### Author:  [@Mayela](https://forum.livingwitheagle.org/u/Mayela)
#### Post date: [December 30, 2014, 5:54am UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/11 "2014-12-30T05:54:45Z")
My doctor told me that only in very, very few cases. And even in those remote cases, the growth would be minimal compared to what you have now. I had mine removed last december and January. It has been a year of total bliss after so much misery.
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### Author:  [@Lisa](https://forum.livingwitheagle.org/u/Lisa)
#### Post date: [December 31, 2014, 5:46am UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/12 "2014-12-31T05:46:47Z")
So glad you're doing well. Im scared to death of surgery but know I cant keep living with these bones/pain. :/
Mayela said:
> My doctor told me that only in very, very few cases. And even in those remote cases, the growth would be minimal compared to what you have now. I had mine removed last december and January. It has been a year of total bliss after so much misery.
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### Author:  [@Snowlady](https://forum.livingwitheagle.org/u/Snowlady)
#### Post date: [January 16, 2015, 2:57am UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/13 "2015-01-16T02:57:06Z")
Isaiah 40:31 said:
> Just found this in another discussion on this forum:
>
> _National Journal of Otorhinolaryngology and Head & Neck Surgery, Vol. 1(10) No. 3, December 2013_
>
> _Conclusion_
> _External trans-cervical approach is better procedure than_
> _intra-oral approach in excising the elongated styloid process_
> _because of better exposure, less operative time, less blood_
> _loss, cost effective, can be operated in high risk patients and_
> _greater length of styloid process can be removed._
---
### Author:  [@July123](https://forum.livingwitheagle.org/u/July123)
#### Post date: [March 29, 2017, 6:35pm UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/14 "2017-03-29T18:35:27Z")
Hi i know what you mean i have the bone protruding behind my tonsil but it hasnt come through the skin yet and im hoping to get the external approach done. I dont know what part of the styloid but it feels round tipped. I was wondering how this gets removed externally because alot of cases are shown intraorally for this. Mine doesnt show up on the scan so i dont know what its like and have a hard time convincing my surgeon cause he cant feel it with his finger.
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### Author:  [@July123](https://forum.livingwitheagle.org/u/July123)
#### Post date: [March 29, 2017, 6:42pm UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/15 "2017-03-29T18:42:29Z")
Mayela i know this is late but if the bone is protruding behind your tonsil can it be removed externally? And could yours be seen on your scan?
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### Author:  [@Jules](https://forum.livingwitheagle.org/u/Jules)
#### Post date: [March 30, 2017, 6:58am UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/16 "2017-03-30T06:58:48Z")
I think it should still be able to be removed either way. Ultimately it’s down to the surgeon’s preference usually- occasionally if a styloid is particularly big doctors seem to prefer to operate externally.
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### Author:  [@July123](https://forum.livingwitheagle.org/u/July123)
#### Post date: [March 30, 2017, 12:04pm UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/17 "2017-03-30T12:04:42Z")
Jules do you mind if i ask you the cost of your surgery in the Uk so i have a rough idea here in Ireland? I will have to pay privately as the public waiting time would be 2 and a half years according to the surgeon. He writing to me in a couple of weeks about costs but im hoping its not crazy money. I dont have insurance.
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### Author:  [@Jules](https://forum.livingwitheagle.org/u/Jules)
#### Post date: [April 17, 2017, 7:28am UTC](https://forum.livingwitheagle.org/t/external-surgery-question/642/18 "2017-04-17T07:28:31Z")
Sorry- just seen this question. I had mine on the NHS so haven’t a clue about the cost, I’m afraid. It was a long wait for surgery though…