Good evening everyone, I am someone suffering from an awful lot of eagle syndrome symptoms, from constant one sided throat and ear pain to a spontaneous carotid dissection last year… Doctors told me my scans didn’t show anything abnormal but i remain perplexed. Currently awaiting cervical MRI results… here attached is a recent dental panoramic xray showing my stylohyoid, in your opinions would you judge this piece of bone to be a culprit ? Thank you so much, happy to have found such a group.
Hi @Northerndad -
Welcome to our community. Your image didn’t post because our software is “protective” to help prevent spam issues here. Once you’ve commented on a couple of threads &/or replied to comments on this one 2-3x your “trust level” will be increased & you’ll be able to post images.
The carotid dissection sounds scary & is something that can go along w/ ES & is referred to as the Stylocarotid vascular version of ES (vES). The imaging you need to have done to show your styloid is compressing your carotid artery is a dynamic CT scan w/ contrast or a dynamic ultrasound. Dynamic means these need to be done w/ your head in various positions i.e. turned left/right, up/down, diagonally left/right, etc. OR if you know that having your head in a particular position makes your symptoms worse, then the scan should be done w/ your head in that position. Often a neutral head position doesn’t cause vascular compression which is why doctors dismiss it.
I have had the contrast scan you mention when hospitalized, unfortunately only in neutral position. It’s quite desperating how doctors here know so little about this diesease.
I accidentally typed jugular vein when talking about imaging you need. I corrected my original post to say carotid artery.
Hi & welcome to the site! Sadly Canada seems to be particularly bad for ES treatments, so quite a few of our Canadian members have had to get treatment in the US- would that be possible for you?
Thanks Jules, unfortunately i doubt that would be possible for me. Hopefully the source of my pain and symptoms is something else, because i’ve rarely seen doctors so clueless, and even routine surgeries can take years here
any ideas if the stylohyoid is that bad from my picture ? Thanks Jules.
It certainly looks elongated, and quite a sharp point at the end! It’s a very cramped space in that are of the neck with several nerves & blood vessels exiting the skull base there, so it’s easy for them to be irritated or compressed…
And welcome to this nice forum. I’m glad you found this page but I’m sorry for the reason you are here and even more for the carotid dissection you already had. Situation in Canada unfortunately isn’t the best too, almost the same like here in Germany. So I’m feeling with you.
About your x-ray I agree with Jules. Your styloid looks within that range where it can cause problems. There are also some signs that the stylohyoid ligament might be calcified in the more caudal part (between hyoid and SP).
From my point of view as interested layman it would be urgent to get a CT scan of your head and neck with contrast like Isaiah said. Bc you already had the carotid dissection I would also considering wearing a soft collar limiting the head movements for the first. That this was from ES isn’t unlikely an can be very dangerous.
Take care until the things are clarifyed. Wishing you finding understanding doctors that treat you well very soon.
Good catch dude ! Pretty sure that’s the little piece of bone causing all that throat irritation !
There might be even more calcification more caudal to the lesser cornu of hyoid. Hard to tell bc of the quality and overlapping. Would be interesting what @vdm and @KoolDude would say. (Just want to make sure they see this.)
I’m still concerned about the carotid involvement - thought avoiding activities causing high blood pressures would maybe be a good idea for the first, too.
Yes i stopped all combat sports , such as wrestling and boxing. Which im pretty sure the hard impacts cause the calcification in the first place… Also stopped all caffeine and hard neck movements.
I get pretty intense throat “popping” maybe caused by this ?
I absolutely agree on this with @TheDude
Elongated styloid processes (which sometimes is actually an ossification of the stylohyoid ligament or in rara cases some other ligaments/muscles) are suspected to cause ICA dissections, causing a stroke. I think it was mentioned on one of the Rybinnik’s (vascular neurologist) presentations/lectures:
(From about 8 min mark)
I also agree with @TheDude. I can see the calcification (cyan circle) although not very clear on this type of imaging. You will need dynamic CT scan in order to see if the Stylohyoid/Styloid is dynamically compressing/irritating your Carotid arteries since you already had a dissection. Pano x ray won’t show much and won’t be enough to justify surgical intervention.