Hello everybody please help with my panoramic x-ray reading!


my symptoms are mainly on the right side

Are you able to have someone order a CT scan with contrast or a 3D CT scan?

I can see the styloid pretty far down on the right (left side of image), next to your jaw.

Yep, I see the styloid coming down on the right too. Where the word "cova" is, on the letter "a". Also, below the jawline where the word "centro" is, I believe that is your stylohyoid ligament and it appears to be heavily calcified. Before I had my surgery on my left side on 8-9-13, mine was very similar to that. My surgeon also removed calcification from my skull base down to my clavicle. It was a mess!!

AmyBlue,

I would be very interested to learn more about your calcification from the skull base. I have a similar issue (called Kimmerle Anomaly or Posterior Ponticle), though I can't seem to convince the doctors as it doesn't seem to show up on the CT scans, only an X-Ray taken by a chiropractor (despised by regular doctors).

I feel certain that both the calcification and the ES are connected. Can you tell me how your doctor discovered the skull calcification? Was it from an X-Ray, a scan or during the ES surgery?

Thanks in advance,

Red Pill



AmyBlue said:

Yep, I see the styloid coming down on the right too. Where the word "cova" is, on the letter "a". Also, below the jawline where the word "centro" is, I believe that is your stylohyoid ligament and it appears to be heavily calcified. Before I had my surgery on my left side on 8-9-13, mine was very similar to that. My surgeon also removed calcification from my skull base down to my clavicle. It was a mess!!

Tiag, I just posted a picture of my 3d ct scan, go to your doctor and demand one, be firm about it. As you can see from my post earlier today it couldn't be easier to see a styloid process


livelycadaver,what symptoms did you have before the surgery and what symptoms you having now ?

Red Pill:

The CT scan the surgeon ordered didn’t show any calcification. It was just something he saw when he got in there and removed as he went along. But calcification does show up on regular X-ray though if it’s heavy enough. I don’t have the technology at home to upload my dental X-rays but before I had my left side surgery my stylohyoid ligament was so heavily calcified that it looks like it had Crest white strips applied to it! I realize how highly rare Eagles is, but imagine how many lives would be spared if the average dentist were schooled in looking for this rare condition! It shows up every day in their offices!


Before surgery the worst part of my pain was a ball of tension behind my ear preventing me from properly resting my jaw which was hell. Now on the left side I have intermittent to constant pain deep in my neck around the styloid and trouble surrounding the actual scar tissue itself. My right side is constantly in pain, occasionally it spikes behind my eye and I wince like bright light just hit me in one side of my face, but it is a constant deep gnawing and aching pain that doesn't care what position I am in it remains unchanged, I am skeptical about having my right styloid removed as my first surgery didn't go great, as you can tell by this picture my left styloid (pictured on right side) is in three pieces....my ent was inexperienced with eagle's surgery so I was the guniea pig, as you can see it just looks like he snipped it and left everything in there...... Look above

Also I can see your styloid process on both sides of the panoramic xray, the only problem with panoramic xrays is they just aren't as beautifully clear as a 3d ct scan, as you can see by mine, spotting the processes is extremely easy.



AmyBlue what makes you think that my stylohyoid ligament is heavily calcified ?

Tiagito78,

While it is impossible for us to know exactly what Dr. Eagle saw- an ossified styloid process OR a calcified stylohyoid ligament- it is my belief that they are often mistaken for each other. My ENT confirmed that, without doing exploratory surgery and taking samples to examine, the medical specialists can't really say for sure. If you go to my home page and scroll down to the documents that I have up loaded, the first article, called "Stylohyoid Complex Syndrome", which seems to be the new proposed name for both Eagle's and a calcified stylohyoid ligament, is something you may want to read.

AmyBlue,

Thanks for confirming about your calcification. I suspect that a simple X-Ray may be a our first line of defense. I am going to try and pick the brains of some Radiology technicians and Radiologists to find out the best method for discovering the presence of calcification, as it seems most doctors won't believe something exists if they don't see it on a film or read it in a radiology report.

HI; just want to ask in case of stylohyoid ligament calcification down to hyoid bone removal of the styloid process is enough to achieve relief or is there a need to remove the stylohyoid ligament ?


Hello Tiagito78,

If the styloid process is normal length and it is in fact the calcified stylohyoid ligament that is the problem, then yes it should be removed, (even if both are the problem, it may still need to be removed). The ligament comes into contact with the same neurovascular structures as an elongated styloid process, the main difference being that it has a fixed path from the styloid process to the hyoid bone, whereas an elongated styloid process kind of takes its own path, sometimes going downwards instead of sidewards.

You need to be sure which one (or if both) is the problem before getting any kind of surgery. Removing an elongated styloid that shouldn't be there in the first place is not going to have the same post op effects as removing the ligament which is a normal part of the anatomy. Hard to say how that will affect your life afterward, though the body does have an amazing ability to adapt.

Red Pill