MRI for "Stylohyoid Tendonitus"

I previously posted this question about an MRI but no one has responded. CT scan with contrast confirmed bilateral calcification and that my left styloid is 3.6 and the right is 4.0. Dr. has now ordered an MRI and the reason is for "stylohyoid tendonitus" (his office notified me). I see him tomorrow to ask for his explanation but I believe he should be ordering a 3D reconstruction of the CT scan b/c that best shows the bones/ligagments he should be looking at. Does anyone have a good reason or idea why he would want an MRI instead? I would like to be "loaded" with knowledge from the wonderful people on this site when I see him tomorrow.

Thank you in advance.

Hi BeachGirl. I would just guess that the doctor is checking to make sure nothing else is there that may be causing the symptoms.

In another post the other day Maui Miracle wrote: "The MRI expecially gave me piece of mind that my symptoms were not due to tumor or any other cause other than Eagle Syndrome and that my brain & brain stem were normal." So I would think the doctor is checking for these kinds of things.

Sorry, BeachGirl, if your previous question was missed.

As Maui Miracle and heidemt said, an MRI can look for problems with soft tissues, so are useful to rule out anything else amiss, plus if they're thinking that there might be pain caused by tendonitis rather than the length of the styloids, it might be why they're suggesting an MRI. I was reading an article yesterday from the journal of Pakistan Medicine- I think it might be on the research info section on this site, but I'll put the link in too- which states the best scan for ES:

'Multislice computed tomography scan with 3D reconstruction can be really helpful in diagnosing the elongated styloid processes and their mass effect on the surrounding adjacent anatomical structures. Scan is also helpful in deciding further management and guides the surgeon on how and from where to approach the surgery.'

You've got the right idea to go in armed with as much info as possible ! It could be that they're thinking an injection into the area would help reduce inflammation rather then surgery.

There is also quite a dispute about the length of the 'average' styloid, and heidemt has researched this. Given that some doctors consider 3-4cms as being not elongated, it might be an idea to read up a bit on this too. One article : shows their opinion and also mentions other papers they've gathered research from. If you have time, it might be helpful to you. Hope that you're appt. goes well, and hope that this isn't too late for you!

So can an mri diagnose eagles syndrome?

A CT is best for showing the SP & calcified ligaments.

Can eagles syndrome cause dizziness or nausea?

Yes- vascular ES can cause dizziness if the blood vessels are being compressed. That can then cause nausea, & also alot of members have had stomach problems possibly from the vagus nerve being irritated, not sure…

You should try to see an ENT doctor who is familiar w/ Eagle Syndrome & request a CT scan to check for Eagle Syndrome. It can be without contrast. That will be the quickest way to either diagnose or rule out ES. Eagle Syndrome is defined as calcification of the stylohyoid ligament OR elongation of the styloid process OR a combination of the two. It can be unilateral or bilateral.

I’m in the process of getting a ct scan scheduled. I’m excited. I’m so ready for an answer. If my throat/swallowing is messed up, could that be my vagus nerve?

It’s great that you’re getting a CT scan!
The facial, vagus, glossopharyngeal, & hypoglossal nerves all contribute to swallowing. Since all 4 can be affected by ES, it’s hard to say for sure which one is causing your swallowing troubles. Typically, I think of the vagus nerve as causing symptoms affecting heart, gastrointestinal tract & potentially anxiety but according to the internet it also plays a role in swallowing. I’m not a doctor so I can only speak from experience & from what I read.
Regardless of which nerve it is, ES definitely can affect your ability to swallow & can irritate your throat. I hope your CT scan shows something very definitive. Please keep us posted.


I choked on a piece of food 3 months ago. It lodged behind my tongue for however long. I haven’t felt good since. All kinds of issues…stomach (severe nause), heart palpitations, anxiety, dizziness etc. it’s been a nightmare. I’m also having a hard time swallowing certain foods. Things feel like they just aren’t going where they should. I cough, clear my throat, have a sore throat, have nose issues. It’s one crazy thing after another. So desperate for an answer.

I totally understand as I had very similar symptoms long before I was diagnosed w/ ES, & I think they were early warning signs. I had an upper GI exam which showed nothing. Ultimately it was neck pain & a hard lump under my jaw that tipped me off that something bigger was going on. Fortunately I was diagnosed w/in a couple of months of those symptoms starting.

Did you have surgery to correct it?

Twice. My ES was bilateral so I had one surgery for each side (11/14 & 8/15). Dr. Samji was my surgeon. Surgery was transformational for me. My ES symptoms are gone. I did end up w/ first bite syndrome, but it’s nothing compared to my ES symptoms.

That’s great that you are better!! I’d love nothing more than to be diagnosed with something that can be fixed!! How was recovery for you?

Also can I ask what your symptoms were and what caused your ES?

Courtney, my doctor just ordered a new CT as my last one was 2 years old and I have not moved forward for personal reasons. I have a new skull base doctor. He also ordered an MRI to be able to see the nerves and other tissue that surround the styloid as well as to rule out any other problems. He ordered the MRI with and without contrast. I will be taking a small dose of Xanax for that test. I hate MRI’s and this one will be double time.
Both give him different but important information. Many doctors go by the CT scan, some feel more comfortable with both. I think I do, also. Many of your symptoms, swallowing and clearing the throat are like mine. I had several gastro tests done and they have mostly been negative, so after years of putting it off, for other medical reasons, I am hoping to move forward this fall and maybe the second one in early spring.

I’m going to answer both questions in this post. Recovery took about 2 months. I was back on my feet & functional after 2 weeks but didn’t feel “normal” until about the 2 month mark. I did have some slight nerve damage to my glossopharyngeal nerve during my first surgery which took about 9 months to heal. The right side of my tongue was paralyzed - not numb, 1/2 my tongue didn’t work right. Full function gradually returned. Even w/ that post op problem, I have NO regrets about having surgery.

No one knows for sure what causes ES. I’ve had a tonsillectomy, whiplash, 2 head injuries & cysts in my thyroid - all of which could have played a role in my ending up w/ ES. However, there are others who have ES who’ve experienced none of those things.
My ES symptoms included the usual throat pain, swallowing issues, neck pain & ear pain. I also had pain at the back of my skull where my styloids attached, felt like my left eye was being pushed out of the socket from behind, heart palpitations, blood pressure drops, vertigo, weird swelling in my gums; I could feel my styloid under my jaw & at the base of my tongue on the left side. I know I had other symptoms, but it’s been long enough since I had my surgeries that I don’t fully remember all my symptoms now.

Wow! Ok. Did you ever experience nausea as a symptom? I’m trying so desperately to find out what’s wrong with me. I know I need further testing. Just waiting for insurance to approve the CT scan and barium swallow. I am miserable.

I didn’t have trouble w/ nausea but many others on this forum have. It seems that GERD (acid reflux) is more often a problem than nausea. Two forum members - Callove and julianeagle, both of whom recently had ES surgery, did struggle w/ nausea as an ES symptom. You could privately email them to get more details.