As @TML noted, bilateral surgeries are done less often than unilateral because of the situation with post op swelling. I don’t know of anyone on our forum who has had bilateral styloidectomies alongside bilateral greater horn resection. We do have a few members who’ve had bilateral styloidectomies alongside bilateral IJV decompression. I recall Dr. Kamran Aghayev does those surgeries.
1 Like
Swelling is the issue with doing bilateral surgery, I wouldn’t say it’s exaggerated, but to be fair, members have been okay with having both sides done. I trusted my doctor when he said ‘it would be too much’, so opted to wait. I guess it also depends on how complicated someone’s anatomy is too; we’ve had members who have nerves tangled round the styloid, others who’ve needed muscle or fascia removed to free the IJV…
1 Like
Ok,
Yesterday, I was refused surgery simply because my styloid process was not considered long. The doctor told me that although he had performed three styloidectomy surgeries, the patients did not improve. He didn’t seem to have training in interpreting vascular CT scans, so it was only natural that he wasn’t familiar with VES. The problem is that most doctors are like this.
2 Likes
Thank you isaiah,
Yesterday, I was refused surgery simply because my styloid process was not considered long. The doctor told me that although he had performed three styloidectomy surgeries, the patients did not improve. He didn’t seem to have training in interpreting vascular CT scans, so it was only natural that he wasn’t familiar with VES. The problem is that most doctors are like this.
1 Like
Thank you , Jules
Yesterday, I was refused surgery simply because my styloid process was not considered long. The doctor told me that although he had performed three styloidectomy surgeries, the patients did not improve. He didn’t seem to have training in interpreting vascular CT scans, so it was only natural that he wasn’t familiar with VES. The problem is that most doctors are like this.
1 Like
I’m sorry that you’re struggling to get a diagnosis of VES- I don’t know if you’d be able to see a vascular head & neck surgeon, or a head & neck cancer surgeon? As they’re familiar with operating in this area, they might be able to help? We’ve been told that many doctors operating on neck cancers have to remove the styloids to access the area, as I said earlier in the discussion… Otherwise you could try getting your scans reviewed by a more knowledgeable person, & then take this back to the doctors? Members have been able to have online appointments with Kjetil Larsen at MSK Neurology, he is very good at spotting things on imaging which other doctors don’t:
Home - MSK Neurology
1 Like
Could you please look into whether left greater horn surgery is possible from a preventative perspective?
I’m feeling a little pain and a tenderness in my right GHHB. If the left torticollis is relieved and normalized to the right after the left styloidectomy, won’t the hyoid bone move to create space? Therefore, it’s important to determine whether or not to have the left GHHB surgery performed during the initial styloidectomy.
here is my cta image drive
and my right ijv foramen is narrower than left
1 Like
@NoneElongatedStyloid Your greater horns (as I’ve pointed out a while back) are close to your carotids. However, a few things…
-
it’s hard to say whether a hyoid bone and it’s greater horns will shift following styloidectomy(ies)
-
it’s hard to say whether torticollis would change following styloidectomy(ies). It’s possible your cervical curvature is the way it is naturally or due to muscle imbalances further down in the body (e.g., hips, thoracic spine, etc.), rather than styloids. But it is possible the styloids are to blame for some of it.
-
it’s hard to say whether a hyoid bone would shift into a problematic position following the straightening of torticollis. Everything (not just the hyoid) would be shifting with the cervical spine, so it’s possible the greater horns would never get closer to carotids, because carotids would be moving too.
-
I can almost 100% guarantee that you will not find a surgeon that will remove your greater horns as a preventative measure. If the styloidectomy(ies) result in further greater horn issues, it is likely only then that a surgeon would touch them.
However, if the greater horns are currently causing you pain, then they are already a problem - they aren’t preventative at this point.
Hope this helps!
3 Likes
thank your advice
If I show my left GHHB image and ask my doctor to remove about 0.5cm, will he be convinced?
Not sure. Depends on the surgeon. But definitely show him and tell him you are experiencing vasovagal / carotid sinus sensitivity due to it. It’ll be more urgent than just pain.
3 Likes
thank your advice
I often have pain near the left lower jaw angle during the day. It may be due to chronic ijv compression, but I don’t know if ghhb and ica are also involved.
Shortness of breath has become a daily occurrence, even when at rest.
And my heart keeps beating so hard it’s tormenting me
1 Like
Shortness of breath & heartbeat are controlled by the vagus nerve. Since you have IJV compression between the styloid & C1, the vagus nerve can also be getting squashed as it runs through the same channel between styloid/C1 as the IJV. This would make sense with your diagnosis. That said, since your ICA/ECA are also compromised, that could also be contributing to your breathing/heart rate challenges.
Pain near your lower jaw angle could be coming from your glossopharyngeal nerve vs a vascular problem.
3 Likes
thank your advice isaiah . Jesus will save me
3 Likes
Indeed He does & will, @NoneElongatedStyloid! I hope you’re able to have surgery very soon so you can start feeling better. 
2 Likes
I agree with @Isaiah_40_31 about the SOB & heart arrythmias you’re having, that it could well be vagus related rather than a vascular issue, & pain under your jaw is a common nonvascular ES issue. Praying you can have the surgery & it’s helpful for you
2 Likes
I’m considering a left-sided whole C1 transverse process resection. Is a partial resection acceptable? Is postoperative stability acceptable?
I’m considering a left-sided C1 transverse process resection. Is a partial resection acceptable? Is postoperative stability acceptable?
It’s often the case that a doctor cannot know how much of C1 will need to be removed until (s)he can see the situation with the IJV, the styloid & C1 with his/her own eyes. I believe it’s not usual for the whole transverse process to be removed from C1 except in very rare cases. Usually it’s only a partial removal of the transverse process, or, if the styloid is cut off above C1, then sometimes C1 doesn’t need to be shaved at all.
I had IJV decompression last year in October & once my styloid was cut back above C1 my IJV was able to be moved slightly away from C1 & no shaving was necessary.
There isn’t a clear answer about whether or not having C1 shaved causes instability. There have been cases where it seemed to occur, but those were often in people who have hEDS or CCI, not usually for someone who does not have one of those diagnoses.
2 Likes
thank you isaiah If you look at my image, it doesn’t seem like the left IJV compression will be eliminated just by resecting the left styloid process. The transvere process is considerably larger than the right.;
1 Like
I’m sorry I didn’t look back at your imaging before replying yesterday so I see why you asked about shaving C1 more severely & how it might affect your neck stability. I’m sorry I don’t have a solid answer for that as the results of a C1shavw can differ between people.
2 Likes