I recently was diagnosed with ES by my TMJ doctor that I saw. I will eventually share more of my story when I have more to tell other than this xray. But let me tell you…when I look at the left side of my xray… I understand why I am in so much pain and discomfort on that side.
What I’m not understanding is my right side. I have the ear congestion on that side as well. and also a constant ebbing and flowing headache that goes from the right base of my skull in like a diagonal behind my ear up into behind my right temple/eye.
Now looking at the right side it doesn’t seem super elongated or broken especially not compared to whats going on with the left. Could the left side be causing these problems as well? Does my right side look a little thick and bumpy? I know you aren’t experts but from what Ive seen I feel like it looks like it should also be looked at majorly, and Im worried the doctors are going to completely ignore it because my left side is so bad.
I know you guys don’t need them highlighted and circled that was just to show my family and friends lol
Let me know your thoughts! Is there any questions I should definitely be asking the doctors? Also like it feels weird to say this but is there ANYTHING to be done for the pain of the headaches and throat? I’m finding it hard to do day to day activities my head hurts so bad a lot of the time.
They appear mildly elongated, or rather partial calcification of the stylohyoid ligament to be more precise, but you won’t know much without a CT scan with contrast, you could go to an ENT or primary care doctor to request they order your CT with contrast and let them know you’re investigating eagle’s syndrome as possible cause of your symptoms.
It’s not always the length of the styloid which causes the symptoms but the angle can do this too; your right side is quite angled, and possibly thicker, plus it’s got quite a wide knobble so could well be causing symptoms…
I’m sorry that you’re in so much pain; there are nerve pain medications which can help, heat and/ or ice can too, and sleeping propped up. There’s more info in this section:
A CT with contrast as @SCJeff says would be helpful, as sometimes headaches can be a vascular ES symptom. So I would ask for this, and ask that it shows the head and down to the hyoid bone, and that if you have a contrast CT that it’s timed to show the arteries and veins.
There’s some suggested questions for asking doctors about surgery, I know that Canadian health care system is pretty slow, so it might be a while before you get to that point but here you are:
How many ES surgeries have they done and what was the success rate?
Whether they’re going to operate externally, or intraoral- through the mouth. Whilst some members have had successful surgeries with intraoral, external is better for seeing all the structures, to be able to remove more of the styloids, & also there’s less chance of infection.
You need to ask how much of the styloid he’ll remove- as much as possible is best- & anything left needs to be smoothed off. The piece needs to be removed too- some doctors have snapped it off & left it in! If the styloid is only shortened a bit it can still cause symptoms.
If your stylohyoid ligaments are calcified, then any calcified section needs to be removed too.
There’s usually swelling after surgery; you could ask if a drain’s put in to reduce swelling, or if steroids are prescribed. It’s not essential, but can help with recovery a bit.
Will it be a day case surgery or will you need to stay in?
Obviously ask the risks- we know from experience on here that temporary damage to the facial nerve is quite common, and also the hypoglossal nerve and the accessory nerve. These usually recovery very quickly but in some cases members have needed physiotherapy. There is also the risk of catching a blood vessel or having a stroke, but these are very rare.
Ask if the surgeon monitors the nerves- this should be done to see if there’s stress on the nerves to avoid damage as mentioned above.
What painkillers will be prescribed afterwards.
Ask about recovery- most doctors either down play it or are genuinely unaware of how long the recovery can take!
We have heard that occasionally doctors use surgical clips which are left in, it’s been suggested that these could interfere with chiropractic adjustments if needed post-surgery, so something to consider, and also we have now seen members who’ve been left in pain from the clips and needed further surgery to remove them, so do ask if they might be used.
@petrichorrr - The upper part & “knob” on your right styloid do appear to be right up against the transverse process of your C1 vertebra. That would mean your IJV on the right has little or no room in that area so is possibly quite compressed. When the IJV is compressed, usually the vagus nerve is too & it can cause pretty significant symptoms on its own.
I looked up the symptoms of IJV and vagus nerve compression and yeah, that pretty much describes everything down to a tea. I’m getting daily headaches that are described as occipital neuralgia and I’m wondering if this is the cause, in which case I don’t know what side I would want done first because my left… I mean look at it, I feel like something it stuck in my throat for years, its itchy, it feels clogged, ear pain, but I don’t get headaches. Right I get the occipital neuralgia headaches, earaches, I can’t swallow on that side of my throat (weird thing that I never thought about being a problem before but if I try I literally choke), plus horrible pain at the base of my head and top of my neck.
I guess in the end I’m really worried my left side is going to get treated and my right side won’t. My mom says obviously they will treat both sides. I’ve been trying to explain the difficulties people have being treated in Canada, and she seems to think there’s a solution so… we’ll see when we get there.
Right now I’m waiting on the call from the specialist to get that special 3D catscan done that I need to figure out if it covers all the areas you guys have suggested getting scanned. So here’s hoping that comes soon!
Thank you for pointing that out Isaiah! I wouldn’t have know that was the transverse process of the C1 vertebra. It does look so close together especially when I pull it up on my phone and look at the picture. And the more I look at the knobbly bit the more I’m like yeeeesh owe no wonder my ears hurt. Quite frankly it makes so much sense as to why my head feels the way it does based on these xrays alone, which is ridiculous because its just a panoramic xray. Ah well, live and learn I guess.
My next steps are going to be a CT Scan with a specialist so I guess it’s making sure that he get’s the hyoid bone and does the contrast and vascular scans… Are these something I can request? He’s supposedly a specialist with a machine that does special 3D cat scans that Im pretty sure Im gonna have to pay out of pocket for but my referring Dr implied this is the kind of stuff he deals with all the time. He also implied that I should get in quickly because the specialist knows the Dr doesn’t refer people unless it’s serious and I wish he hadn’t because I’ve been waiting by my phone like a teenage girl waiting for a boy she likes to call.
I’m glad you’ve been referred to someone who hopefully knows about vascular compression- definitely request a CT with contrast as described; a normal CT will show the styloids, but as you do have symptoms of possible IJV compression then it makes sense to find this out, and CTs do have radiation so not good to have more than you need. If you do have to pay for this and you can afford it then it’ll be worth it hopefully. If you need to, print off a couple of the research papers which show symptoms like yours to argue your case!
Typically the referring doctor has to request the specific area to be imaged, & whether it should be a dynamic or static scan. As far as I know, a patient can’t make a specific request regarding what & how imaging should be done once at his/her appointment.
Well I’m gonna suggest the hyoid bone if I can and hope for the best haha. I’m sure the Dr I had referring me requested the best scans cause he did mention something about it compressing stuff. Here’s hoping the doctor I had requested them right!
@petrichorrr - You should be able to check with your doctor’s ofc or the radiology lab to find out what was ordered & get the order updated prior to your appointment date if it’s not correct. You won’t want to go through another round of radiation anytime soon if the order isn’t correct.
