Found out the surgeon lied to me after hyoid surgery

I have been having worsened swallowing discomfort and throat irritation ever since I had an operation to disconnect the right stylohyoid ligament from my hyoid 3 years ago.

The surgeon encouraged me to have an operation which he described as a simple and safe alternative to having a styloidectomy. At worst he said, it would not help. He described the operation to me during the consult as resection of the lesser horn of the hyoid on the right side and removing a portion of the stylohyoid ligament. The op report says exactly the same - “identified SMG (submandibular gland), identified DM (digastric muscle). Resected lesser horn. Stylohyoid ligament noted to be thickened”. That’s it - 4 lines of writing.

The surgeon changed his attitude significantly when I woke up from the operation when he told me it was a difficult operation but went ok. During the follow-up appointment 1 month later I told him that my swallow was significantly worse and that it felt like something sharp was sticking into the back of the throat when I swallow. Also there is muscle tension causing a globus sensation and the whole area feels unstable. Also sometimes when I swallow, the thyroid cartilage pops to the left and catches on something (?transverse process of vertebrae) only to pop back into place a few seconds later. This happens in various head positions.

He told me that there was no way that hyoid surgery could cause swallowing issues. I have since been told that this is simply not true. I have also been told by various specialists that they would not have attempted such an operation - which is easy to say in retrospect.

The same surgeon agreed to do a styloidectomy 5 months after this initial operation. At this point I felt I was unlikely to find anyone else in Australia who would do one. I asked if he could do it via external approach for more complete removal but he said he would only do it via an internal approach.

He managed to only remove between 10 and 15mm of my approx 43mm process. In the process I developed quite major TMJ problems on the affected side which have not improved in the 2.5 years since. I had not had any TMJ problems prior to this. It seems that he may have overstretched the jaw during the operation damaging the external ligaments. The disc appears intact and in position on MRI. He also stated that he removed all of the attachments from the process which I don’t feel should have been necessary given the amount removed. Cutting the stylomandibular ligament may have contributed to the TMJ issues. There is discomfort behind the right jaw line where I can feel what I assume is this ligament bunched up at its insertion point. I also now get paraesthesia (tingling/tugging) on the right side of my tongue whenver I open my mouth widely and in certain head positions.

I recently saw a new ENT who ordered a CT scan. This is the first CT scan that I have had since the op as even though I asked the surgeon who operated to do one he refused. Also the radiologist that specialises in head and neck was supposed to read the scan, some other person did. It was very inaccurate - described the left styloid to be longer that the remaining portion of the right - which it is easy to tell is wrong on the 3D images. He also was mistaking a segment of calcification in the left (intact) stylohyoid ligament as being a tonsillolith despite the fact that the referral clearly stated that I had a prior tonsillectomy.

I asked for a second opinion from the radiologist who was supposed to read it and finally got one after 2 months of hassling them.

The report shows that a portion of the right greater horn of the hyoid was been removed. This was never told to me. I am not sure why it would have been done but perhaps to try to gain access to the ligament. It is only a small portion but obvious when comparing the pre-op CT with the post-op CT. I believe that this might be irritating the throat. After reading the report I stuck my finger down my throat and felt around and it is actually easy to feel the sharp point just sitting in space - it feels like a nail with only a thin layer of mucosa over it. I have very little gag reflex on that side.

The report also states that the lesser horn appears intact. So am not sure if he even did the intended procedure.

I can’t believe that I sat across from this guy and told him that it feels like something sharp is sticking into my throat from that area and he said nothing. The report also clarified that the right styloid remains longer that the intact left - 28mm vs 22mm. I asked for angles of the process to be assessed and the report stated that the angle on the right (symptomatic side) is 60 degrees from the skull base in the coronal plane whereas the intact left side is 85 degrees. Some studies have proposed that a smaller angle (indicating a medially pointed process) correlates with symptoms more than length.

I have included a few 3D images. I also shows that the whole hyoid/thyroid assembly is slightly displaced from its original position. There are also 15 surgical clips in my neck distributed right from just under the skin through to the mucosa. The report said that it was impossible to determine if these have caused a fibrotic change that may be contributing to issues. This makes me think that it is a possibility.

I know what some people are thinking - sue the guy. I am not the litigation type but even if I wanted to proceed with a compensation claim I could not. I just want relief from my symptoms. In my state in Australia there is a strict 3 year timeframe to start proceedings for medical negligence claims which has passed. In addition to that I would have to get an expert to state that my issues were definitely caused by the procedure and that I had permanent disability which is difficult to say as I can still eat food and drink. Also I had pre-existing swallowing discomfort.

I would not have agreed to this procedure if I had of known that it was not as simple as he made out. Now I am in a position that I have had 2 surgeries, each with its own set of new problems and all of my pre-existing ones too. This new ENT does not want to operate on me just like the previous ones that I have seen since the op (I think i’m up to 4 ENTs and 2 oral surgeons). He wants me to see a neurologist. I have already seen 2 and they both said there is nothing they can offer.

I have completely exhaused conservative measures with physical therapists, musculoskeletal doctors, speech therapists. I am now at the point of considering further surgery - but what? More complete removal of th styloid process maybe. That wont help with any issue caused my the hyoid though. Perhaps some kind of procedure to remove the sharp tip of the hyoid bone… There is no way I am going to be able to convince someone to go back in there.

People living in the US should consider themselves lucky that there are at least a couple of surgeons that take the right approach to surgery for Eagle’s Syndrome. I wish I had access to them but even if I could find someone to help me, being the sole wage earner for my young family I simply could not afford to do so. I am in a deep hole now.

I wonder if anyone has had a similar operation on the hyoid which has then led to swallowing issues. I have read journal article describing total resection of the greater horn of the hyoid without it causing issues - but these articles are often bias as they are written by the surgeons who do not want to report negative outcomes.

I also wonder whether anyone has had issues on one side but proceeded to have both styloids removed. There is some calcification at the hyoid end of the left ligament and I do wonder if there is tension pulling ti to that side. I would be reluctant to have the same surgery on the other side though after my experience.

Really sorry that you’ve been through all of this and are worse off than before. We are hearing of more members with hyoid issues as well, but not enough feedback so far to know what their outcomes are from surgery. It sounds like you’ve researched it all as well as you can and know as much if not more than the doctors you’ve seen. I can understand that you’re reluctant to have more surgery- it does sound like it would take someone very experienced to operate, and like you say- there’s not that in Australia.
I hope that maybe some other members can tell you their experiences with any hyoid surgery, and thanks for respecting the site’s policy on not naming doctors, however frustrating that may be.
Thinking of you…

Thanks Jules.

We have it bad here in Australia.

I wonder did we have the same surgeon?

I had supposed “right styloidectomy” in Oct in Victoria. Cost me a fortune that I don’t have. Had a small stroke during surgery.

Surgeon said he “left 1cm of the elongated styloid and left a nub of the ossified ligament”…

I have had various scans since, including xray and OPG which show that NONE of the styloid has been removed and that a small segment of the ligament is left floating around my carotids.

The surgeon refuses to communicate with my GP who has written and asked exactly what was done in the surgery and what caused the vascular accident. The surgeon denies (now when it is too late) that vascular ES even exists.

We are not allowed to bad mouth surgeons on this forum and yet it leaves us, the patients, with no way of letting prospective patients know the risks of dealing with dodgy surgeons. There are simply not enough (if any) specialists in Australia for this rotten condition.

I feel for you, truly, without anyone knowing about this, we can’t even seek compensation.

Della, FNQ

For legal reasons we can’t name these doctors, I can understand your frustrations though. You didn’t have the same doctor, but feel free to mention names in private messages, as you’ve both done to us Mods. I will be updating the doctors list soon, and will make sure that they’re not on there, as you both have had pretty bad experiences though… I do keep an eye on where any new members are from so would’ve forewarned anyone from Australia if necessary until the list is updated, so don’t think that we’ve had lots of people who’ve seen these doctors since you two did. There is lots of info on the site about questions to ask your surgeon to try to judge how experienced they are, but that’s not always a definite way to tell, and that is why we don’t ‘recommend’ doctors, but have put together a list of doctors members have had a positive experience with.
I do really feel for both of you, and hope that you both can find some help.

Don’t how you would stand legally but you could set up your own forum and express your views there. But take care and advice 1st !

So sorry it has come to this for you.

Take care :heart:

Thanks but my main concern is to try to get someone who can help me. I think naming and shaming the surgeon would make this very difficult.

Have you any friends or family that work in a hospital with ENT maybe they could do some research for you ? Sorry I was a bit off track before.

I do actually work in a hospital but ENTs only visit for consults. It is just too complex for most people to want to get involved despite their best intentions. They are concerned it will make things worse as it is out of their scope. Most are empathetic just don’t want to take action.

I was almost thinking of setting up a crowdfunding campaign to try to get to the states but I don’t have much of a social circle and don’t want to involve the friends and family I do have. Don’t think strangers would really understand and there are people that are worse off than me. I really want to get this sorted for my family’s sake as I am not able to be the best partner and father feeling rotten all the time. Thanks for your advice and thoughts though. Mark

As everyone else has said, I’m so sorry to hear about the condition in which you find yourself. Just wanted to add that some of the U.S. surgeons will do phone consults once they have your CT pics/results on hand. You might be able to have a phone consult with Dr. Samji or Cognetti for a fraction of the price of flying here. That way you would at least have the opinion(s) of the two doctors here that are most “in the know”. I know Dr. Samji would be straight with you about whether or not he thinks there’s anything that could be done to help you.

There is also the surgeon in Mexicali, Mexico who has recently operated (externally) on a couple of people who so far have had good outcomes. These 2 people went through a “medical tourism” program. I have no info about that, but I believe you could message THH to get details.

I am so sorry for what you’ve gone through & continue to suffer. It makes me sad.

Hi there, I have recently had a successful full styloidectomy in Sydney. My ENT specialist was awesome. I am not sure where you are located but my guy is highly recommended. Sent me a PM if you want to find out more, or check my other threads.

Hope this helps,


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