How do I properly measure styloids on a CT scan?

General
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Hi there – For years I have experienced neck and shoulder pain and muscle spasm, light sensitivity, head pressure, migraines, sinus congestion, and other assorted symptoms. So far, I haven’t really been able to find a diagnosis to explain or treat these symptoms; daily migraine preventatives keep the pain manageable but it’s really limited my life. For what it’s worth, my symptoms switch sides back and forth on a cycle – not sure if that weighs in favor or against a possible case of Eagle. I also a hard spot on my neck under my jaw (on the right) that it very tender and sometimes produces a trapped nerve sensation, followed by relief when I press on it.

I am curious if Eagle could be the culprit, but given that seemingly all of the specialists in California do not take insurance and have hefty consultation fees, I am debating whether to pursue a consultation/if a diagnosis is likely or worthwhile. To that end, I’ve tried to measure my own scans, but am not sure if I’m doing it right. I’m attaching them below – any guidance would be much appreciated. Thank you!

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@ap65 - It looks like you have ES based both on your symptoms, & the lengths of your styloids. Additionally your right styloid is pretty thick at the top & your left one is oddly shaped.

On this forum, we really don’t concern ourselves a lot w/ length alone when it comes to considering whether a person may have ES or not. We’ve learned over many years that a normal length styloid that is extra thick, curved, angled oddly, pointed, twisted, or misshapen can cause the same types of symptoms as an elongated styloid &/or calcified stylohyoid ligament.

Below are doctors who do take insurance for ES surgery in California. I think the initial consult with any doctor affiliated w/ a hospital or medical center would be covered by insurance. Those in private practice can choose to charge a consult fee not covered by insurance.

•Dr Dinesh Chhetri, UCLA, Los Angeles (ENT/ Otolaryngologist, Head and Neck Surgeon) Dinesh K. Chhetri, MD - Otolaryngology - Head & Neck Surgery | UCLA Health

•Dr Gerald Berke, Los Angeles, UCLA Medical Center 310- 794- 8634 (has reportedly done ES surgery, but not on any forum members that we know of) https://www.uclahealth.org/provider/gerald-berkemd

•Dr Brendan Gaylis, Scripps Clinic, Torry Pines, La Jolla 1- 800- 727- 4777 http://www.scripps.org/physicians/4128-brendangaylis-md-facs

•Dr. Theresa Guo, UC San Diego Medical Center - Theresa Guo, MD | Otolaryngology, Surgery | UC San Diego Health
Blvd, Suite 5200, Sacramento, CA 95817, 916-734-5400 tel, 916-734-6774 fax, Assistant/Receptionist - Ivy Hamilton, 916-734-1759, Kaicheng Lawrence Yen, M.D., Ph.D. for UC Davis Health

•Dr Hussein Samji, Camino ENT Clinic, San Jose 408- 227- 6300 Camino Ear, Nose & Throat Clinic (one of the most experienced ES surgeons in the US, does external surgery.) Does do online or phone consults. Contact his medical assistant Yerelin@caminoent.com for a faster response. (Dr. Samji doesn’t believe in vES).

•Dr. Edward Joseph Damrose, 801 Welch Rd, Palo Alto, CA 1-650-723-5281 Edward J. Damrose, MD, FACS | Stanford Health Care

•Dr. Kaicheng Lawrence Yen, UC Davis Health Department of Otolaryngology, 2521 Stockton
Blvd, Suite 5200, Sacramento, CA 95817, 916-734-5400 tel, 916-734-6774 fax, Assistant/Receptionist - Ivy Hamilton, 916-734-1759, Kaicheng Lawrence Yen, M.D., Ph.D. for UC Davis Health

If you have Kaiser as your medical insurance company then the doctor you’d need to see is in Sacramento -
•Dr. Brian Jian (Neurosurgeon) & Dr. Balough (Neurotologist) & Dr. Ji (Neurosurgeon/Neurointerventional Radiologist) - KAISER SACRAMENTO, 6600 Bruceville Rd, Sacramento, CA, 916-688-2000

Now that you have more complete doctor information, I hope you’re able to get a diagnosis & get those spikes taken out of your neck as that is the only reliable way to get your symptoms to resolve.

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Thank you so much for this information!

FYI, Dr. Samji no longer takes insurance for Eagle consults and charges $500 out of pocket for the initial consult. I spoke to his office earlier today and was frustrated to learn this.

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That’s frustrating with Dr Samji, he’s done lots of surgeries for members…
I agree with @Isaiah_40_31 about your styloids, they could well be causing symptoms, so it looks like it’s worth pursuing ES as a diagnosis… hope that you get an appointment with one of the doctors on the list soon!

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@ap65 -
Dr. Samji is the only one of the doctors who’s in private practice on the list I gave you. I mentioned private practice doctors generally charge out of pocket fees for initial consults, however, Dr. Samji does take insurance for the surgery he does. I didn’t put Dr. Osborne on the list because he doesn’t take insurance at all though his initial consult fee is lower - $250.

The remaining doctors on the list are all affiliated w/ a particular hospital or UC Med Center so initial consults should be covered by insurance. It’s good there are a number of options w/in California for you.

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