Images Update from Dr. C

Hi all,

I finally got my images back of my 3DCT. The radiologist noted bilateral ossification of the stylohyoid ligaments but did not say anything else. Images are below.

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The side that is symptomatic is my right side the one with the connected ligament that looks curved or angled like a “little harpoon” as Dr. C called it. They aren’t terribly long looking however I can now see why he called it that looking at these images. Could the angle be causing me to have such bad pain?

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The angle, the curve on the bottom half of the right styloid & the thickness of the left styloid & the calcified piece of ligament are all most likely contributing to your symptoms @Donoel.

Were you able to schedule surgery!

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I agree with @Isaiah_40_31 , also the right side looks like it’s quite pointy at the end…

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Yes its interesting that one side could be so much more problematic. That’s why I wonder if I got one side done (my right) would I start to notice more issues on the left.

Last night my dog got excited and hit me in the neck when he jumped on me. All day I am having worse clicking and gurgling in my throat when I swallow. The globus sensation is also much worse. I am scared now that it made it worse since it already is such a sensitive area with thing going on?

I feel like im just so anxious and don’t know if I am overreacting or if its even possible to make it worse just from that. I don’t have any bruise or swelling. I am not sure how hard you would have to be hit in the throat to cause damage but as you have mentioned people can fracture their styloid just from laughing or yawing.

Also one more thing to note a few years ago when I heard the pop and I went to the oral surgeon and he said it looked fractured is that something you would be able to see on these images?

Thank you all!

Emily

Also I have not scheduled surgery, I still need a follow up with Dr. Constantino after her reviews my images. I got the radiology report back but all it said was.

image

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My main symptoms are throat and tongue pain. I am taking Lyrica to help with some and it seems to be taking the edge off of the nerve like pain. Its only on that right pointy side that I have pain and feels like it harder to swallow. I feel like the other side with the floating piece i have no symptoms besides tinnitus and sometimes I can hear my pulse in that ear but not constantly.

@Donoel,

Your dog most likely only caused the nerves that are already irritated to become more irritated which is what increased your pain/symptoms. Your styloid is protected from outside stresses by muscles & other soft tissues so I’m guessing your body’s reaction is from angry nerves.

It’s hard to tell exactly which styloid is causing which symptoms until one is removed. During healing of from the first surgery, symptoms from the remaining styloid often ramp up. They can even cross over to the side that’s already been removed.

I’m interested in what Dr. Costantino says when you have your consult. He pretty strictly works with patients who have vascular outflow obstruction (translation: compressed internal jugular veins).

Based on this statement you made, it doesn’t sound like you have IJV compression. If he doesn’t offer you surgery, we can refer you to other doctors in NY or more local to you or you can check our Doctors List.

It’s hard to tell whether your styloid is fractured or if it’s just jointed. There are 3 classifications of elongated styloids & yours looks to be to be Type 2 - Pseudo articulated which mostly means where the styloid process meets the calcified stylohyoid ligament, it looks like it’s jointed rather than being one long smooth elongation as in Type 1:
Morphological-classification-of-type-of-styloid-process-by-Langlais-et-al-Type-I

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Thank you so much for sharing this image. I will follow up with Dr. Constantino and I might try and get a second and third opinion with Dr, Amino and Dr. Cognetti. They aren’t that far. Unless there are some other god doctors in the NY-CT area that I missed.

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We have at least a couple of other doctors on our Doctors List for NY but haven’t heard much about them on our forum.

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