Wow, they are very long styloids! Not an expert, but it does look as though they are very close to the C1 processes too, which is a common area for the Internal Jugular Veins to be compressed, so that could potentially be causing raised intra-cranial pressure, and can cause vision problems. There is a small amount of calcification on the ligaments where you’ve circled too, we have seen members who have symptoms from small patches of calcification on their stylo-hyoid ligaments… your hyoid bone processes look pretty long as well, they look like they’re quite close to your spine- we’re seeing more members with hyoid bone syndrome from elongated hyoid processes, the symptoms from this seem to be strangled, choking feelings as well as trouble swallowing, which you don’t mention, so maybe these aren’t causing problems for you?
How much experience has your doctor had with surgery? That’s something to consider when you’re trying to decide if it’s right for you, here’s some questions that we suggest members ask their doctor:
- How many ES surgeries have they done and what was the success rate?
- Whether they’re going to operate externally, or intraoral- through the mouth. Whilst some members have had successful surgeries with intraoral, external is better for seeing all the structures, to be able to remove more of the styloids, & also there’s less chance of infection.
- You need to ask how much of the styloid he’ll remove- as much as possible is best- & anything left needs to be smoothed off. The piece needs to be removed too- some doctors have snapped it off & left it in! If the styloid is only shortened a bit it can still cause symptoms.
- If your stylohyoid ligaments are calcified, then any calcified section needs to be removed too.
- There’s usually swelling after surgery; you could ask if a drain’s put in to reduce swelling, or if steroids are prescribed. It’s not essential, but can help with recovery a bit.
- Will it be a day case surgery or will you need to stay in?
- Obviously ask the risks- we know from experience on here that temporary damage to the facial nerve is quite common, and also the hypoglossal nerve and the accessory nerve. These usually recovery very quickly but in some cases members have needed physiotherapy. There is also the risk of catching a blood vessel or having a stroke, but these are very rare.
- Ask if the surgeon monitors the nerves- this should be done to see if there’s stress on the nerves to avoid damage as mentioned above.
- What painkillers will be prescribed afterwards.
- Ask about recovery- most doctors either down play it or are genuinely unaware of how long the recovery can take!
- And a link to the info about surgery in general in case you’ve not had a chance to read it:
ES Information- Treatment: Surgery - Welcome / Newbies Guide to Eagle Syndrome - Living with Eagle
For most people symptoms do tend to get worse with time, the only real cure for ES is surgery, but it’s not something to rush into and you do want to make sure that your doctor is experienced and can remove as much of the styloid processes as possible to help resolve symptoms.