Extraoral vs Intraoral surgery?

I have been reading about the types of surgeries, it appears the best way is the extraoral approach, are there any Intraoral successful surgeries and how does a dr determine which approach is best for you? Is it determined where the stolid location or the drs ability?

This is a great question. Hope someone can shed some light. I’ve wondered the same thing. I’ve read intraoral has less visability for the surgeon but is less invasive and has a shorter down time. The doc would probably just reduce the size of the styloid. The neck approach has clearer view and gives the doc a chance to see more…and possibly do more…However : there are a lot of nerves- etc in this area. Longer down time possible. My thought is I’d want to know how many my doc has done of either one! My question would be does external give you better results long term…? We are all looking for a cure and not a temporary fix! I think its all about Drs

I am having surgery on Feb 4th. The doctor said he is goig to try and go internally first although if he can't get it from there he needs to go externally. He told me that it is less invasive going internally and I can go home that day but if he needs to go through the neck i will be spending the night in the hospital.....

Unless there are complications during surgery, intra & extraoral approaches both allow the patient to go home the same day, that is unless you have bilateral surgery done - i.e. both sides at the same time. Because of throat swelling issues, people are usually kept in the hospital overnight after a bilateral surgery as the throat can swell closed. The only reason I could think of that Imunique's doctor would keep her in overnight if he tried both approaches would be because of the potential for serious throat swelling. If he cuts the inside of her throat & doesn't feel he has good access then goes by the external approach, she'll have double swelling - both from the internal & external incisions - which will probably require some sort of longer-term (overnight) medical intervention to keep the swelling down in her throat.

I have to say, Imunique, that I'm a bit surprised this doctor would take a chance on trying both approaches in one surgery. If he has any question whether he can access the styloid by the internal approach, he should skip it & do the external approach & save you from having to recover from 2 incisions & the extra swelling & recovery time involved. If I were you, I'd get him to commit to one or the other for your safety. What your doctor is proposing seems a bit outrageous to me.

Please forgive me if my response seems blunt, but I'm 2 months out from my first extraoral surgery & am still recovering. This isn't something to be taken lightly. I've read on this site & been told by my doctor that it takes about 6 months for full recovery from surgery. I'll be having this done again in May to take care of my other styloid. That means a total of 1 year recovery time. YIKES!

I will be praying for you all to have wisdom in choosing your doctors, as you make your surgical decisions, & for the best possible outcome for all of you post surgery.

Isaiah 40:31

Hi Snowlady,

There are lots of people that had successful intraoral surgeries. But the "main" more experienced doctors who do Eagles surgeries primarily do extraoral. I think that a couple of them may do intraoral surgeries once in a while if they feel the situation warrants it. I'm pretty sure I've read that Drs. Cognetti and Forrest have done intraoral surgeries on occasion.

From everything I've read (and experienced myself), intraoral surgeries are supposed to be more painful and take a little longer to recover from.

To me, the main issue is that more of the styloid can be removed through an extraoral approach. But as I said, there have been lots of successful intraoral surgeries. If you're one of those people who would do fine with only getting some of the styloid taken out, then you would probably be fine with an intraoral surgery. The chances are pretty good that you only need part of the styloid removed. The problem is that you don't really know that until after the surgery is over. I'm one of those cases where I needed more of one of my styloids taken out after an intraoral surgery.

There is a lot of information back in prior discusssions and I would urge you to read back and see what experiences people have had.

I forgot to add that I don't know why the less experienced Eagles doctors tend to use intraoral. I think it may be easier for them and I think they don't realize they should take as much of the styloid out as they can. I know I've read a couple times where doctors pretty new to Eagles want to take a "conservative approach", which to me means more agony for the patient down the line.

If you need more of the styloid taken out, it's much harder to find a doctor to do a revision surgery than an initial surgery. Also, after the first surgery, scar tissue starts to develop. If there's a lot of scar tissue, it can be much more difficult, if not impossible, to get as much of the styloid taken out as you need with a revision surgery.

I just thought of something else. There really are some occasions where an intraoral surgery is the best option. I know one forum member Shawn, (I don't think he'll mind if I talk about him) had a botched operation where the first doctor missed taking out the styloid completely. He had a lot of problems for years after that surgey and finally found a surgeon who fixed him using an intraoral surgery, which he had to do I believe because of the scar tissue built up.

I believe the risk for infection after an intraoral is greater.