I have a "concerning" question for those of you who can answer!

I am waiting surgery to remove my right styloid process but I would like to know if doctors always remove the stylohyoid ligament or just detach it from the tip of the styloid ? I asked my surgeon and he just said to don't worry about it ! ok ! but if gets detached and not removed wouldn't it then start to move and stab everything in the area where it was detached ? can you picture it in your mind ? please anyone?

My doctor specifically said he removes the ligament & cuts the styloid off as close to the skull as possible. The stylohyoid ligament is sort of like your appendix - in that, it's something you can live without & won't notice when it's missing. It's not a major player in the proper functioning of your body. I would insist that your doctor tell you what his plan is. It's your body. You have the right to know what he's going to do to it.

I hope this helps!

Isaiah 40:31

I had this same question. It would seem to me that you would want the ligament removed, especially if it is calcified and hard because it would seem like that could potentially be causing some of the irritation in there. I haven’t had surgery yet, but have been studying anatomy charts to try and understand why I have the pain and symptoms I have…good luck, and. Happy Holidays!

I very strongly suggest that you make sure that your surgeon removes the entire ligament if it is calcified and as much of the styloid as possible.

I had surgery a couple years ago and my doctor removed just 2cm of my styloid (there is still 2.6+ cm) and left the calcified stylohyoid ligament just sort of floating in there. Not only did my symptoms not really improve much, they may have gotten worse.

It is not just the length of the stylohyoid ligament and bone that it important but the angle. If the angle changes significantly (i.e. the bone is pointing inward) then it could cause more compression and much worse symptoms.

I am still trying to find someone who will definitively remove this whole mess. I am having the worst imaginable symptoms. I have spells of almost fainting, weakness, tinnitus, carotidynia, incredible trouble thinking, heart symptoms, shock like pain in my face and episodes of shaking almost like a mild seizure.

I probably have some combination of glossopharyngeal nerve compression, vagus nerve irritation, carotid or jugular vein irritation.

I don't know what is going on with you but if your ligaments are calcified (have you looked at your CT scans?) then I would insist that you have them removed. They should cut from the lesser cornu of the hyoid and have them cut the styloids as far back to the base of the skull as possible.

jrodefeld I have all the symptoms you mentioned too ! but by looking at my ct scan I don't see any stylohyoid ligament calcification ! have a look at my picture please and tell me if you see any calcification of the stylohyoid ligament !

Do you have regular CT's (not 3d reconstructions)? It is a bit hard to see what is bone and what isn't from that angle.

tiagito78 said:

jrodefeld I have all the symptoms you mentioned too ! but by looking at my ct scan I don't see any stylohyoid ligament calcification ! have a look at my picture please and tell me if you see any calcification of the stylohyoid ligament !

I have a regular ct scan but doesn't show much , it was done just to measure the length of the styloids (right 4.8 cm and left 3.7 cm) about 3 weeks ago I went to see another doctor (not the one who ordered the ct scan) and told him about all my symptoms and that I could feel a bone behind my tonsil HE looked at the scans and said couldn't see much but noticed that my hyoid bone is a bit big however he couldn't tell me if causes problems or not ! the he offered to remove my right styloid process but never said anything about the ligament !

jrodefeld I have all the symptoms you mentioned too ! but by looking at my ct scan I don't see any stylohyoid ligament calcification ! have a look at my picture please and tell me if you see any calcification of the stylohyoid ligament !

If you have calcification of the ligament, do you kind of hear a grinding/grating noise when you open your mouth on that side? I have been trying to figure out what this is and I have been told I don’t have TMJ. Thanks

Looking at the CT scan, if the bone horseshoe-shaped, below the jaw, is the hyoid, it looks clean and without calcification. The styloid seems to be leaning against the carotid and this could be the reason for some discomfort. But this is just a guess, because the angle of the image and the mixture of structures in a single color difficult to understand.

Brazilian you are right about the styloid compressing the carotid , the thing is I have so many symptoms and can not figure out whether they are related or not , I also have a big hyoid bone according to my consultant, but don't know if causes symptoms !! FRUSTRATED AND IN SERIOUS PAIN !!

Kay what you describe seems like a tmj issue !

tiagito: Thanks for response. This is something I have just noted recently. I went through five dentists who did not feel I had TMJ, but I am wondering if I have developed this too; I just wanted to see if anyone had it related to ES.

Kay have you had your styloids measured ? if so how long ? also is there any calcification of the ligaments?

Tiagito78, I would strongly recommend getting the entire ligament removed. My doctor said he was going to remove the entire ligament since it was mostly calcified and he didn't want it to recalcify after surgery. He said there is no reason why he wouldn't remove it since there is the possibility of recalcification.

tiagito78: My right one is about 4 cm and left 3.5 I believe I recall from my CT done in July. I wasn’t up to speed enough to ask about the ligament and whether or not it was calcified…this site has provided invaluable information for me, so I will have more intelligent questions when. I see another ENT in January regarding the possibility of surgery. Thanks for asking. I think I will try and get that free software that was mentioned…how do you measure the styloid length on a CT? Hope everyone had a wonderful Christmas!

Once you download the software you will be able to measure the styloid by pressing the tab [measurements]and then tick the box [length] left mouse click on begining of the styloid and drag the line up to the tip of the styloid ,but first you have to create your 3d volume ,to do that you have to insert your copy of the scan into the DVD drive of your computer and then run the program ,click help if you need instructions! Hope you had a good Christmas too! Mine could have been better if

I wasn't in such situation ! Don't forget to show us some pics

I have bilateral ES. I just recently had surgery on the left side December 9th. Both styloids were/are elongated and close to 5 cm. The left side where I had surgery was fully calcified and sticking into my tonsil fossa. After the surgery my doctor told me that the ligament was completely fine and there was no calcification. So she detached the ligament and just cut down as much as she could of the elongated styloid. I too was concerned with the ligament and what it will do, if it is still pressing on nerves/arteries etc. I am still experiencing some beating in my head and neck, some palpitations. It could be that the nerves are still adjusting and need to "learn" how to go back to normal since they have been compressed for such a long time. That can take months. The extreme dizziness and feeling that I am going ton pass out/have a seizure or heart attack seem to be gone. That is a huge relief! That was/is the scariest symptom for me.