Thank you for the suggestion about Dr. Chhetri, I’ll call his office and ask if they can do a virtual consult! Thanks for the explanation of what could be going on. My symptoms sure sound similar to what you described. Now looking back, I wonder if I’ve had issues going on for awhile and didn’t realize. I was told they were anxiety. I’m actually fairly sure I have some sort of instability in my neck as well, I didn’t even know what it was called/how to describe it until I saw someone ask a question on this forum and I was able to look up what it was called. I’ve had bad neck pain for many years and always assumed it was due to tight muscles or guarding from nerve pain, but in the last few years I’ve developed painful snapping right at the base of my skull every time I move my head, and “shifting” bones in my neck if I turn too fast. I’ve never been able to get a diagnosis for what specifically it is and usually end up with “tight muscles”. Do you know if there’s ever been a connection made between Eagles, hyoid bone problems, and cervical instability?
The glossopharyngeal nerve can often be affected with ES, & some people have described it as feeling something wet in their ear (I’ve had it occasionally), so it could be that, or jugular compression can often cause head & ear pressure so it feels like ears are blocked, like you’re under water, if either of those sound like you have?
ES and CCI do seem to be linked; whether as some believe the styloids calcify more to ‘stabilise’ the neck when the ligaments/ muscles are weak, or whether because of styloids causing vascular compressions in the neck the body unconsciously adjusts head positions to alleviate the compression & so weakening muscles, leading to CCI , who knows! Even doctors don’t agree…
We’re seeing more members with elongated hyoid bone processes too, I guess whatever is causing styloids to elongate could also affect the hyoid processes too as they’re all connected…
@leo see attached annotated images (3 here, and 3 in following post)
Between the skull base and C1, your left styloid is compressing your left IJV. On your right side, the styloid is touching the IJV but there isn’t a concerning amount of compression happening.
Down at the level of C1, neither of your styloids are compressing the IJVs. However, both IJVs are pancaked against the wings of the C1 transverse process.
Further down, your hyoid greater horns are not compressing anything, but the left greater horn is in contact with your left ECA.
In the following post I am posting 3D images. Your left styloid measures well over 3cm, while your right is nearing 3cm. I’ve also noted that you’ve lost your natural lordotic curve of your cervical spine (i.e., the curve is opposite to what it should be).
If you are considering surgery, I would think that a left styloidectomy where the styloid is cut as close as possible to skull base could help your left IJV open up. You could also consider a C1 shave on both sides, but not sure how much that compression could be contributing to things. I think the greater horn potential issue could sort itself out if the elongated left styloid is removed, but hard to say.
Hope this helps! Not a doctor nor radiologist.
edit: I’m just re-reading your original post which says you already had a styloidectomy. In the CT imaging you sent me, both your stlyoids are fully there. Do you have newer imaging that I can look at since your styloidectomy was done?
@leo - We’ve had a number of members who’ve had symptoms of both ES & potentially hyoid bone syndrome. Since the hyoid is connected to the styloid via the stylohyoid ligament, I think there can be an association between the syndromes. A calcified stylohyoid ligament tether’s the hyoid bone so it can’t move as it needs to when one talks, breathes, coughs, hiccups, sings, etc. That tethering could potentially cause changes in the hyoid producing HBS.
Thank you so much for such a thorough look at my CT, it’s really kind of you to help me and other members here! Oh gosh, this IS my new imaging 
. This was taken a year and a month after my styloidectomy. Can styloids re-grow? Originally my right styloid measured 3.2cm and my surgeon sent me a picture of the sizeable chunk he took off…I want to say he said it was at least 1.5cm maybe 2cm? He didn’t want to go any farther up because of my anatomy but he said I should only have about 1cm left.
Yes to both of those! I often feel “underwater” and like my hearing is muffled and I actually went to an audiologist because I felt like my hearing was being affected. I have slightly reduced hearing in my right ear but nothing super concerning according to the tests. I also get the “wet” feeling several times a day along with an insane amount of (sorry TMI) post-nasal drip. I do get sharp nerve pain now that runs down the back of my throat, maybe that nerve is being affected?
I had never heard of CCI before, but when I looked it up I was shocked that it describes my neck pain perfectly. That may not be the issue of course, as I’ve never gotten a definitive diagnosis, but it sure sounds suspicious.
I wonder if this could be what’s going on. I would occasionally have pain in my hyoid area before my styloidectomy but I always assumed it was from muscle tension/eagles because it would come and go. After my injury, it’s become pretty constant 24/7. I can provoke most of my symptoms by just pressing on the hyoid area. Do you know if surgery is always required for this? I know we had talked about myofascial therapy, have you seen any folks recover using this method? While I recovered fine from my styloidectomy specifically, my body went nuts after my surgery and I developed an unpleasant health condition from it so any further surgery would need to be my last resort.
@leo measurements in radiantviewer may be slightly off, but it definitely looks like your right styloid is longer than 1cm. If it were 1cm, it would end probably halfway between the skull base and C1.
Styloids don’t typically grow back. And if they did, that much growth in 1.5 years would be insane.
Nonetheless, from a vascular standpoint, your right styloid doesn’t seem that bad, but your left is causing quite a bit of IJV compression between the skull and C1, which puts it on a trajectory to be compressed against C1 as well.
Yes, styloids can regrow. We don’t see it too often, & it’s usually 2+ years after the original styloidectomy before someone comes back to say theirs regrew. I may have had regrowth or my left styloid wasn’t cut as short as I was told. I didn’t have a follow-up CT scan until 7 years after my left styloidectomy to see why some symptoms had come back. At that point, it was found to be compressing my IJV which was missed first time around. I’ve had 3 ES surgeries & am hoping I’m done. I totally understand you not wanting to go through surgery again if you ended up with a secondary problem post op. Frustrating for you for sure!
That’s rough if you’ve had surgery already & the styloids have re-grown; not sure of your age, but we did have a teenager who had to have second surgeries both sides as his regrew quite quickly…
If you want to avoid surgery it might help to look into exercises to restore the natural lordotic curve of your neck as @TML pointed out, yours seems to have gone into the reverse of this…some members have found this can improve symptoms, although for others it could be your body’s way of trying to make room in the neck for the IJVs so it might not help, there are exercises to try in this post:
List of my favourite resources on YouTube to learn anatomy - General - Living with Eagle
Sleeping propped up a bit can help with IJV compression, so worth trying…
@leo - Above are pictures of the way a cervical curve should look (left picture) & two abnormal variations that can happen due to poor posture, neck injuries or genetic difficulties.