I made my scan 3d tell me you think

All I can say is WOW! SO AWESOME! Dr. Sorenson sounds like a doctor who needs to be added to our list! I’ll wait to hear how your surgery goes before giving him a place there though.

What he has proposed for you sounds just perfect. The facial nerve dissection he referred to is likely dissecting the facial nerve away from muscle or other connective tissue that may need to be removed w/ the styloid. This would serve to protect the facial nerve. BRAVO that he does nerve monitoring, too!

I felt certain there was a doctor in your state who would be familiar w/ this surgery. I’m so glad he’s finally turned up!

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That’s not something you want to have done. Better try to clarify this with their office.
Dissecting the nerves means they would be cut for ever. I am pretty sure the doc has something else in mind as that would leave your face paralyzed.


That sounds good! Nerve monitoring is usually done to make sure the nerve isn’t stretched too much, hopefully as @Isaiah_40_31 says it’s just dissecting away from the surrounding tissues and not literally dissecting it, as @vdm says it would mean permanent paralysis so I would’ve thought that would’ve been mentioned (& would be extremely unusual!), but best to double check!
I had a drain in, they’re very good in that they do reduce swelling and the risk of infection, but can be pretty uncomfortable, just to prepare you!
Hope that you get a date soon!

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Interestingly, in my internet searching about the facial dissection, i came across a short video of Dr. Ryan Osborne (I considered having him do my styloidectomy) talking about this during paratidectomy surgery. My takeaway was that the most important aspect of successful facial nerve dissection is the surgeon having much experience doing it. I feel confident Dr. Sorensen has lots of experience after 20 years as a Head & Neck Surgeon, so that box is checked!


Forgot to include the video link : How do you achieve facial nerve preservation in parotidectomy surgery? - YouTube


Thank you for the link, @ jschronce! Very interesting info.

I am now scheduled for surgery next week, January 20, with Dr. Sorenson. Wanted to circle back to the “dissection” discussion. I asked Dr. Sorenson about it, and he explained there will be no cutting of the facial nerve! Dissection in this case refers to the necessary process of separating neck tissues and gaining access to the facial nerve to identify it and ensure that it is avoided via active monitoring throught surgery. He said if cutting it were intended, it would be called “transection”.

I have more to share, but should i start a different thread?..


Thats awesome, hope you have a speedy recovery and must importantly some relief. I have a tele appt with Dr Osbourne tomorrow afternoon and im a bit nervous. I really don’t even know what to talk about at this point… Do you have any recommendations or insight for my appt? it kinda sucks when a doctor apppt feels more like a interview


Were you able to send your imaging to Dr. Osbourne? It took took several different failed electronic attempts for me, until they learned that my imaging was done at Cedars-Sinai, which they had access to. He reviewed them before our conversation, and noted the “split-lesion” calcification may be causing some of the symptoms I described. My styloid lengths are not really elongated. Not sure if he planned to remove the entire styloid, so that’s something to ask Since both your styloids are elongated, I would think he would be willing to do the surgery, but which side, or will you ask for both to be removed? He didn’t feel additional imaging was needed for my left side case, which is clearly a calcified ligament, to do the surgery. I had his staff send the estimated cost and paperwork to fill out, but ended up choosing someone else more local to me in WA state, Dr. Douglas Sorenson. He can do it sooner, he’s in-network for insurance, and I believe he is a very experienced and competent head and neck surgeon, with at least some prior styloidecomies performed.


Yeah i sent my ct scans through dropbox. i only have symptoms on my left side which is ironicallly the smaller side, but is also much think and touching my atlas. I want a surgeon here in tampa but the Drs recommended on the site for florida havent returned my callls. the Ent i saw close by stuck his hand down my throat and couldnt feel it and said its not eagles.

I’m so sorry you haven’t gotten calls back & the doctor you saw who felt your styloid claimed it’s not ES. That’s ridiculous, @Cazmagic! I don’t think the styloids can be easily felt in the throat unless they’re elongated (someone please correct me if I’m wrong!).

I suspect you’ve read that it’s not just styloid length that plays into symptoms. Sometimes normal length styloids that are very thick, angled, twisted or pointed cause the same problems as an elongated styloid &/or calcified stylohyoid ligament. There must be some feature of your left styloid that’s making it cause worse symptoms than the right one.

Things to ask Dr. Osborne would be

  1. Does he do bilateral or only unilateral surgery?
  2. If only unilateral, how many months required between surgeries?
  3. Does he electronically monitor nerves during surgery?
  4. Does he do the external approach? (We know he does but does he always do it that way?)
  5. How much styloid does he remove or how much does he leave behind?
  6. If this is relevant to your situation - How does he handle vascular ES cases i.e. compressed internal carotid artery or jugular vein - Does he make sure the vessel(s) is/are decompressed before closing the patient up?
  7. Is the surgery outpatient or does it require a hospital stay?
  8. Does he Rx prednisone to help reduce post op swelling?
  9. Expected recovery time post op?
  10. How many ES surgeries has he done?

Please let us know how your appt. goes.


Thanks i definitely will ask, but I’ll have to wait until he offers you surgery. You remember my other post my left styloid is 37mm and right is 44mm, but the left probably twice as thick. Thanks for the support

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Thanks for posting the link to your previous discussion. I hope some others check it out & comment on it. I’m definitely not the most experienced at looking at images.

Feel free to start another thread if you want to post about your journey @jschronce- really pleased for you that you have a date for surgery & that it’s not too long to wait! Will pray for a good outcome for you :pray:

@jschronce :partying_face::partying_face::partying_face: Your surgery date is coming up soon! We look forward to hearing from you when you feel up to it post op & are, of course, here for you should you have pre-op questions. :hugs:


How did you do this??!?! I would like to have all my recent scans converted to this. Not sure I believe the radiologists that have read my CT scans. Please advise. Thank you.

@vdm just posted info in this thread:

Hope this helps. Dr. Osborne doesn’t take insurance its all out of network. He offered surgery, but its 20k and possibly 32k. He agreed with the 2nd report was more accurate about the lengths and not the original. Some of these reports only measure in the coronal view and not the MPR ( multi planer view) which is more accurate. I’m looking to make a appointment with Dr. Samji (does take insurance), but he only accepts original reports and non contrast ct scans which i dont have and my orignal report it bogus according to me and Dr osborne. So much bullshit with this condition.

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Thank you for the scoop about Dr. Osborne. It’s a shame he doesn’t take insurance & then has such astronomical fees for his service. Dr. Cognetti is also a great choice, & he does take insurance, and his cash price for those who are uninsured is only about $4k which includes anesthesia & outpatient surgery center.

Dr. Samji did both of my ES surgeries (2014/15) & I’ve had excellent results, however, we’ve had some members who haven’t had such great outcomes after his surgeries & some have found in follow-up CT scans that he didn’t remove as much styloid as he claimed to. Because of my experience w/ him, I highly recommend him, but if you choose to have surgery w/ him, make sure you get to actually see your styloid post op so you can see how much was removed. He will not take pics for you, & he doesn’t do the nice image w/ the styloid lying against a ruler. You have to ask one of the surgery center nurses to please retrieve it so you can get a look before it gets sent off to the lab for testing.

He is an excellent surgeon & knows what he’s doing so it’s hard to explain why the inconsistencies in surgical outcomes. I recently had a CT scan because of some recurrent ES type symptoms, but my styloids look to be non-existent so this problem is coming from elsewhere. Based on that info, he did great by me.

I know you said you’ve tried contacting a couple of the ES docs in your state but got no response back. If you weren’t persistent in calling, you might want to continue that route as well to save your self the time & cost of traveling. Many of our members have had trouble getting in contact w/ doctors offices recently because everyone seems to be short staffed after the COVID shut down.

Here are 3 who have been highly recommended by our members:

•Dr Rui Fernandes, University of Florida and Shands Hospital, 653-1 8th St W, Jacksonville, (904) 383-1018, https://hscj.ufl.edu
•Dr. Anthony Bunnell, UF, 653 W. 8th St., Jacksonville FL, (904) 244-3216 https://ufhealthjax.org/doctors/3099/anthony-bunnell/
•Dr. Phillip Pirgousis, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, (904) 953-2000

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