@Anon - You did a fine job of providing a couple of 3D images. Your styloids aren’t super long, but they are very thick at the skull base & look pretty pointed. The left one looks like it’s curving inward a bit, too. I can’t tell if you have IJV compression because there isn’t enough of the IJV visible in either picture. Is there a way you can zoom out a little in the pictures to show more of your neck? With what I see, I think your styloids could definitely be contributing to your symptoms.
It also looks like you may have an arcuate foramen on the left side of your C1 vertebra. That’s a situation where a bony arch exists on the vertebra. For some people it’s inconsequential but for others it can cause pain & other symptoms.
I tried looking at your images in the dicom library link but couldn’t figure out how to see more than the thumbnails that came up. I can tell you that you have a problem that many of our members have & that is loss of the natural cervical lordotic curve. When the cervical spine straightens out, the styloids automatically move closer to nerves & vascular tissues in your neck. A straight neck is called “military neck”. Restoring the lordotic curve is possible, but it takes time & patience. Here’s a link to a post with some helpful information about that:
It’s not that clear though to say for sure, the other blood vessel next to it could be causing some compression…
Th axial images like you’ve posted can often see the compression more accurately , if you could post some other ones of these, like this level for example if you have it:
My hope is to visit either Mr Axon or Hughes privately, would mr Axon be more suited? Unfortunately both are a 4 hour car ride away, therefore i would love to know what i am dealing with before i go, as I have a 10 week old baby logistically it isn’t the easiest to work around.
Hopefully these are more useful, i don’t seem to have the exact view you’ve posted.
@Anon - If you have a 4 hr drive one way or the other, Mr. Axon should be your preference. Mr. Hughes doesn’t operate to resolve IJV compression if it’s present. Mr. Axon does & that’s his specialty. I believe you can have a telehealth consult with him initially so you don’t have to drive that far & could receive a diagnosis that way. I know he does telehealth consults for international patients so I expect he’d do them even if you’re across your own country from him.
Your right IJV appears to be your dominant IJV as it’s much larger than the left one. It’s very common for the two to be different sizes. I agree w/ @Jules that the right does look like it’s being compressed between the right styloid & transverse process of C1.
I’ve annotated a couple of the axial images you’ve sent but am not 100% sure everything is labeled correctly. That said, I think there is sufficient evidence of IJV compression for you to make an appt w/ Mr. Axon. You can see that your IJV is oval bilaterally in the images below which is an indication of compression. It appears the cause is more C1 than your styloids, but I could be wrong. Best to rely on a doctor’s opinion.
Something else I noticed in one of the 3D images you posted today is that your left styloid looks to be sitting very close to your internal & external carotid arteries. It may be a function of the angle of the imaging, but it’s certainly something to ask about when you talk to a knowledgeable doctor. I can’t tell if there’s a similar situation on the right because the right mandible is in the way & the image doesn’t show as far down the neck.
I agree that Mr Axon would be the best bet; he does do a C1 shave if this is needed; obviously we’re not doctors here, but your C1 processes do look quite long… And as @Isaiah_40_31 says, he does do virtual appointments. Best wishes to you, can’t be easy feeling rough and navigating this with a young baby!
Hi @Anon I am UK based and consulted Mr Hughes & Mr Axon. Had Styloidectomy & C1 TP resection with Mr Axon five weeks ago through the NHS. Please feel free to PM me if you would like any further details
Thanks for all the recommendations, I had my virtual appointment with Mr Axon. Unfortunately he does not believe I have any kind of jugular compression from my styloids or c1 process and doesn’t believe my symptoms match with that of eagles syndrome, I am at a bit of a loss now.
I want to encourage you @Anon, all is not lost! I would get a second opinion personally. I don’t have “huge” styloids length wise, but my symptomatic side is very similar, thick, angular and oddly shaped. Please don’t lose hope! Some doctors (I have no idea about that doctor, I am speaking broadly) have outdated or rigid ideas about Eagles Syndrome…
You have been doing amazing advocating for yourself!
@Anon - Honestly, I’m very surprised that Mr. Axon doesn’t think you have IJV compression.
Another option would be to get an appt with De. Aghayev to get his opinion. Getting a couple of opinions is recommended by our forum as one doctor often sees what another misses or dismisses.
