Intubation with Eagle Syndrome

I work in a high acuity Skilled nursing home that has several people on ventilators. No one has Covid-19. I started thinking about the the procedure of intubation with Eagle syndrome and looked it up in some medical journals and sure enough because of calcification of stylohiod ligament or/and elongated styloids, it creates difficulty lifting the epiglottis during the porcedure. What can happen if the surgeon isn’t aware of your Stylohyoid ligaments, is that there can be structural damage , that can be permanent or fatal and/or there can be regurgitation that can be fatal. I took the liberty to get myself a medical bracelet that says"Eagle Syndrome Intubation Risk" on the front and "Calcified stylohyoid ligament , scope before intubation " on the back. This just gives me a little peace of mind in the event I contract Covid-19 and wind up in ER.

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Very good idea! I know that several members have been very concerned about this with having the ES & other procedures & have mentioned it to the anaesthetist.
You might find this article interesting too:

Hope that you don’t get the virus…keep safe as much as you can.

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Hi Hirocooper,

I recall you’ve had ES surgery. Is intubation still a problem if the styloids &/or calcified stylohyoid ligaments have been removed? Maybe I’m remembering wrong re: ES surgery for you.

I am interested to know your answer. One concern I have is that my stylohyoids were removed from the hyoid. The hyoid has only a few muscles, ligaments holding it in place. I would think that area of the throat would need gentle care.

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Hi emma,
Last night I started reading some of the older blog posts that go back before I was a member here. I found a brief discussion about intubation in one of them. Here’s the text:

Jan '14

Cat, Boy, I am so ready after the past couple of years. Besides all the medical balony, there has been some serious personal problems here. But little ol me is always the one who makes sure everybody else’s life is ok. With a little help from some (very few) supporters, I am girding my loins… Trouble is at my age, just being normal can be tiring.

On to Glitter Paws…

My vocal cords are constantly inflamed and I was told it could be from GERD and nasal drainage. But I really don’t have that problem. However, I think back to knowing about the VAGUS nerve, which controls all of our autonomic behavior and this could be part of the problem if it is irritated or whatever. I know part of my problem became rather serious after being intubated and I fought it, my voice was very raspy. I think this could have started the cycle to where I can’t deal with it. But when no one dr. really has a handle on the whole picture, that is my worry.

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eagleheart

Jan '14

I was in a car accident and then had a back surgery to repair the accident damage… Being intubated immediately started my symptoms up. I think the car accident started the growth, and then being intubated got the symptoms going.

Not a single doctor (and I’ve seen many) has attempted to speculate on the cause.

Here’s the link for the whole thread (it’s a long one): Curious as to a cause

Isaiah_40_31

I never had the surgery. I had researched it but I will reserve this option as a last option.

Emma,

I am not sure what your question was.

Emma was “seconding” my question: Is intubation still a problem once the styloids/stylohyoid ligaments have been removed or only if they’re still present & elongated/calcified?

If your pain becomes debilitating &/or you can’t enjoy the quality of life you’re accustomed to, surgery is the next step. It gave me my life back. Dr. Samji is the BEST!! I’m 5.5 & 4.75 years out from my surgeries.

Right now, there are certain symptoms that are persistent such as the tinnitus, the feeling that something is poking me on both sides of my neck when I sit in certain ways that can be very uncomfortable and painful at times. Periodically, I have severe pain that makes me feel like I am having a heart attack . That has happened 3 times. I have had vertigo probably a dozen times. Once and if the pain gets more frequent I will consider surgery and hope and pray to have the experience you did. I did contact the doctors office and they requested a copy of my CT scan, which I requested from Kaiser but never heard back. I am a bit apprehensive still . i feel as though I am living with some discomfort, but knowing the cause is a huge comfort. I am so grateful for the referral. I should also consider the doctors age and how long he will be in practice in to my conditions. I would only want him to do a surgery based on your recommendations!

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Hirocooper,

If you want to pursue surgery via Kaiser, we’ve had a couple of forum members who have had or are going to have surgery done at Kaiser Hospitals. One was in Sacramento area & one pending in So. CA. In both cases, an ENT & Neurosurgeon will be/were present for the surgery. Ilovemaui2000 is the member who had bilateral surgery in the Sacramento area. You can privately email her to see how she is doing now. She hasn’t posted much since her surgery so I don’t know how well she’s recovered. I believe JoyS is the member from So. CA. If you’re choosing to go out of network, I’ll be happy to support you in that direction as well.

Your heart pain is most likely being caused by an irritated vagus nerve, & vertigo could be vascular compression but can also be vagus nerve related as the vagus nerve can cause blood pressure fluctuations, & if your bp drops quickly, vertigo can result.

If the referral you’ve mentioned is Dr. Samji, I’m guessing he’s in his early-mid 40s & has done close to 500 ES surgeries - more than any doctor in the US as far as we know. He is a very skilled surgeon has a great bedside manner.

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Thank you so much for your feedback and information. It has really been very helpful for me. I am glad to hear that Dr. Samji is so young so I have time. I will have to decide within the next few years as I am 60 . The older I am, the more risky any surgery becomes. I work in healthcare and still work as much as I can. Thank you again for your thoughtful responses.
Teresa

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I had my ES surgeries at age 58. I’m 63 now. It took about a year for me to fully recover from my first surgery. That said I was fully functional 2 mos after surgery but for nerves to heal took longer. My second surgery was more “textbook” but a number of months post op were still required for nerve healing. Bear this in mind as you consider your age & rate of healing/recovery which slows as we get older.

As long as you’re functional & not in debilitating pain, surgery can be postponed. When you get to the point where working/living is very difficult due to ES symptoms, you’ll know it’s time for the next step.

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