I finally met with the surgeon today. He said he doesn’t remove the entire styloid due to all the vasculature at the top part of the styloids. He mentioned leaving it at the normal anatomical length. Is that common? He said its a misconception that the styloid is elongated. Its really just a calcified ligament. Does any of this make sense? Thanks
I’m glad you finally had an appt. w/ your prospective surgeon, @11bravo. Most surgeons won’t remove the styloid to the skull base even if they say they do. A stub of varying size is usually left behind. I believe most surgeons aim to cut the styloid back as close to the skull base as they feel is safe which means the styloid will be cut shorter than the normal anatomical length, for example, 1 cm vs 2.54 cm. This can make a difference between great surgical results & so-so results. If possible, try to get a second opinion. There are several surgeons on our list who are in your state. Someone else may approach ES surgery differently.
When I was diagnosed w/ ES, the ENT told me I had calcified stylohyoid ligaments which he called Eagle Syndrome. Since then I’ve learned that there can be true styloid elongation & stylohyoid ligament calcification that causes the styloid to appear to elongate i.e. the ligament calcifies from the tip of the styloid & down toward the hyoid bone as opposed to calcifying from the hyoid bone end up toward the styloid (this can happen as well). I had one styloid that I think was actually elongated because it didn’t follow the line of my s-h ligament but my other styloid elongation was definitely caused by a calcified s-h ligament. I hope this makes sense.
I would definitely want more info from this doctor- what does he mean by ‘normal anatomical length’? If you do have a calcified ligament is he removing that part only? If so how long are your styloids? Doctors consider up to 3cms, sometimes longer is normal, but this can still cause symptoms. And will any remaining styloid be smoothed over?
I had purely elongated styloids- 4cms each side- which were removed to the skull base. My ligaments weren’t calcified, so your doctor is wrong about that. I would get a second opinion as @Isaiah_40_31 says…
Thanks for the input. He was my 2nd opinion. He was one of the top physicians recommended on here. He said the styloid would be cut to about 1cm. I was definitely a little confused on the styoid elongation and ligament ossification being the same thing. Do you think it matters either way since hes dtill removing the styloid?
He mentioned removing the styloid to 1cm on both sides. His explanation of the problem was a ossified ligament. His explanation of the procedure was a styloidectomy. Either way doesnt the ligament get removed if the styloid is removed just by it being attached?
I need to do a little back paddling here & say it sounds like the second opinion doctor’s surgery would be pretty thorough i.e. calcified ligaments would be removed & styloids cut back to 1 cm, thus, he’s definitely worth considering. Cutting the styloids back to 1 cm does make them pretty short & definitely less likely to be causing a problem. Dr. Cognetti, one of the more experienced ES surgeons on our Doctors List, routinely cuts his patients styloids down to 1 cm or slightly less, & his surgical outcomes have largely been very good.
Yes it does. The ligament between the styloid process of the mastoid and the hyoid bone becomes calcified. My son had his recently removed and surgeon said he took out approx 50%. My son’s sx have improved. Never hurts to get a second opinion if you don’t feel comfortable w current doc.
If the styloid is shortened to 1cm that’s good, and yes, if the styloid is removed to that length the ligament would have to be detached from it. If yours is calcified then it sounds like it’s calcified from the styloid process & along, so will be removed. My ligaments weren’t calcified so were detached & left in, I’ve not noticed any difference!
Ya Dr Cognetti would be ideal. Unfortunately he’s too far. The doctor i saw was Dr. Bunnell. He seems to have a good reputation. He was definitely nice talking with and seemed knowledgeable but its also a lot to process which causes my confused. He wanted me to take some time and consider weather to move forward or not.
What did they do with the end of the ligament that was connected to your styloid?
Dr. Bunnell has really helped several of our members so he’s definitely worth considering.
Just freed it & left the rest in I’ve not had any problems since, so try not to think about what it’s doing, flapping about in there !