I can still feel the ES symptoms on both sides. My husband told me that the ENT did not remove the left styloid completely but small end part, not to where it should be removed under the base skull and still have full right styloid. What can I tell the neurosurgeon and/or ENT? I am already have an appt with CT w wo contrast for ES. This will send to Dr Osborne.
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It’s almost impossible for surgeons to fully remove styloids. Because there are way too many important nerves up at the base of the skull. So almost all surgeons cut the styloid to be between 0.5-1cm which is what they did to your left styloid. Your right styloid is obviously still long since it hasnt been operated on, but your pain is on the left side of your neck. The surgical clips are the only thing in direct contact with your carotids and they would move with neck movements so I can almost guarantee they are causing your syncope episodes.
The fact that you don’t know why you have clips in your neck tells me that your surgeon never told you that he left clips in there. This is very concerning to me. You have chunks of metal floating around in your neck around your carotid artery
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The CT 3D was done from last June or July 2024. The clips may be related to fusions. Should I ask the doctor to have clips to remove due to pain and irritation?
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What I would do is bring the images I annotated to your doctor and ask him why there are random surgical clips floating around in your neck and ask him if they are causing vasovagal response when turning the neck.
The 3D CT that I uploaded is your CT from this month.
When you uploaded the 3D images to the forum they were from the 2024 CT scan. The 3D images I just uploaded are from your CT scan this month, showing the shortened left styloid and showing all the surgical clips left in your left side of your neck.
Can you see what the date says the most recently?
When I was in your portal the scan said it was from this month I believe. You can go to your portal and double check. Whenever you would’ve had your most recent head/neck CT
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I think maybe the ES surgeon left surgical clips in your neck after he was done the styloidectomy? Or they were left in there during a different surgery?
The 3D from 2024 (the 3D that your initially posted) had no clips and an elongated left styloid. The 3D I just uploaded of your most recent CT scan has clips in your left side of neck and a shortened left styloid. I think the ENT that did your styloidectomy left clips in your neck and now they are causing you issues.
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So are you saying that this is going to be the rest of my life? Is this sounded bad news. I hope not.
You should get clear answers from your ENT surgeon or family doctor (probably best to confront the ENT) as to why there are upwards of 10 chunks of metal surgical clips in the left side of your neck. Do they serve a purpose to stay in there or did they forget to take them out after surgery. Your symptom profile speaks to carotid artery irritation/compression and your imaging clearly shows metal clips in contact with your left internal carotid artery. The metal clips can also bump into nerves causing pain.
If the clips are causing this then it isn’t for the rest of your life. Your symptoms should go away if the surgeon goes back in to remove the clips.
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Can you tell me the name and date of the order of 3D? Or send me the snapshot of the images you found.
@bdys the CT scan was done on September 7th, 2025. So earlier this month. I already uploaded all the screenshots of your imaging if you scroll up.
I just wanted to write a summary statement here to make sure I am as clear as possible and that there isn’t any confusion:
When you first posted on this forum you posted a 3D model of a head and neck CT that was taken in 2024. That CT was done before your left styloidectomy as evident by an elongated left styloid in the imaging. There were no clips in your neck at the time as evident by the imaging. You then got your left styloidectomy done. And then you got a head and neck CT scan done on September 7th (this month). I have accessed your health portal and opened the report from that CT and I also gained access to the actual imaging. The CT shows a shortened left styloid to the length of probably 0.5-1cm which is great, however it shows that there are roughly 10 metal surgical clips in the left side of your neck - not by your vertebrae but along the side/front of the left side of your neck. My guess is that the surgeon who did your left styloidectomy used surgical clips during the surgery but then forgot to remove them after the surgery and that these clips are now causing your symptoms. The fact that you were never told by the surgeon after the surgery that they left surgical clips in your neck makes me think that they forgot to remove them after surgery and that they aren’t supposed to be in your neck anymore. I would suggest reaching out to the surgeon with the screenshots of your imaging I posted above and ask them about the clips. Some of the clips are in direct contact with your left ICA, in an area really important for regulating blood pressure and heart rate.
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WOW! I don’t quite know what else to say.
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Can you help me how to say to the ENT? I’m still in the process of CT w wo for ES for Dr Osborne. I need to get the best surgeon who knows ES to do the right side as well as left side of needed. Should I send the recent test results and images like what you sent me so far?
I am lost at this point.
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I know it feels that way but you are not lost. The answers are right in front of us. There’s two ways you can go about this.
Option #1: Reach out to the surgeon who did your styloidectomy and ask him why there are surgical clips still in your neck. Tell him that you can email him CT images showing the clips. Tell him that you have been having stroke-like symptoms and tell him that you think some of the clips are in contact with your left internal carotid artery.
Option #2: get the CT done that Dr. Osborne ordered and then when he reviews it, ask him about the clips in your meeting with him. I don’t think he is going to do anything further with your left styloid as it has been cut pretty nicely, but he still might want to remove the right styloid. Removing the right styloid doesn’t address the clip problem. Whoever you see, they need to remove those clips out of the left side of your neck.
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My husband is upsetting to see me torturing with pain. He is angry with the surgeon(s). He is concerned and wants to see me to get back to my life.
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You’ll get your life back. Just need to get those clips dealt with
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@bdys - Yes, we have a number of people in this group who’ve had cervical fusions then had to deal with ES afterward. You aren’t a lone in that.
I think @TML has given you a very thorough explanation of what is likely going on & causing your symptoms. Dr. Osborne can verify that what TML said is possible/likely, but Dr. Osborne is not the surgeon you want doing your surgery because of your right IJV compression being caused predominantly by your C1 vertebra. You will need to see one of the surgeons who does a C1 shave i.e.
Dr. Nakaji, Dr. Costantino or Dr. Cognetti w/ Drs. Costantino & Cognetti being closest to you.
When you have your follow-up consult with Dr. Osborne, please show him the two 3D images that TML uploaded here which visually show the surgical clips pressing into your carotid artery & jugular vein on the left side, & ask him if he thinks those can safely be removed. If so, Dr. Costantino might be the better surgeon for you to see for the IJV decompression since he seems to take on more challenging cases, but you could also opt for a consult with Dr. Nakaji once you have more information from Dr. Osborne.
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