My reconstructed scan from my dentist was dismissed by ent

I have Facial, neck, and shoulder pain only on my left side. Im taking migraine medication, got branch blocks in my neck and still have pain every day. when i look down my tinnitus gets much louder almost like a on/off switch. My head gets caught in the styloid area unless i horizontally move my head left, then i can look fully down. When i put my chin down i can litterally push into the styloid area with my had and crack it every time, im honestly wondering if the things broken. It feels like my shoulder and head are almost fighting for a spot. Ive done head/neck mri, head w and w/o,shoulder mri, all normal besides degenerative disks diease and mild stenosis at c5-c6 and possible labrum tare. I would love your guys opinion on my left styloid it look like it has knob near the top. Im no radiologist but to me that left c1 dont look right either. I need help on what scan to ask for i tried bring it up again today with my doc and have a head ct, but from what im reading i need a head and neck ct… oh and now im getting vision problems


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Hi @Cazmagic,

Welcome to our forum! I’m glad the software let you upload images first thing. It usually blocks them till you’ve posted a few times.

Both of your styloids are very long but the left one is also very thick especially up at the top. This could lead to compression of your internal jugular vein which can account for your tinnitus & visual changes. An elongated styloid process especially when it’s thick like yours or very angled can compression the IJV against the transverse process of the C-1 vertebra when the head is in certain positions (thus a person will notice symptoms are worse when head is in particular positions like looking up, down, left, right, or diagonally in any direction, etc).

Your left styloid does look like it might be fractured diagonally near the top as does the right one which also looks to be jointed. Pretty complicated set up you have going on in there.

The type of scan you need is a head & neck CT w/ contrast to look for IJV compression on both sides. If you can travel, I would recommend that you see Dr. Bunnell or Dr. Fernandes in Jacksonville.

I hope this helps!

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Thanks for taking a look! Can the ct with contrast be reconstructed just as accurate than without? Honestly i cant even feel the right styloid at all

Yes, a CT scan w/ contrast can be reconstructed in 3D it’s just that your soft tissues will be visible & may obstruct the view of your styloid to some degree & depending on the angle, it can be completely. If the CT tech knows to scan for IJV compression, the angles of the scans should be such that both the styloid & C-1 are visible as well as the IJV.

You won’t be able to request a change of body area for the CT once you’re in for the scan. We have a number of members who’ve tried & all have been denied their requests. That requires a doctor’s order.

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They look nasty & very pointed, I’m surprised you’re not having trouble both sides! As @Isaiah_40_31 says, they could have been fractured at some point, although they can grow with ‘joints’, & sometimes it looks like a joint where the styloid process stops & the stylo-hyoid ligament starts to calcify.
I’d be careful pushing on the styloids, avoid it if you can, as you could fracture it & cause yourself more pain & problems…
I hope that you’re able to get some help from one of the experienced doctors @Isaiah_40_31 mentions!

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Yeah I probably shouldn’t be popping it. I did have a 30lbs cross fit ball hit that area a few times in a row. I wonder if that set it off, but that months after this. Would those 2 doctors accept an appointment without an eagles diagnosis?

@Cazmagic - You should be able to schedule an appt for a discussion about ES & take your images with you to share with them (or the ofc may ask you to send images ahead of time so the doctor can review them prior to your appt).

It’s always good to get a couple of opinions so seeing both isn’t a bad idea. You may find you feel more supported by one than the other & with this syndrome, you definitely want to see a doctor who supports you well.

YIKES! about being hit in the neck/head w/ a 30 lb crossfit ball!! :scream:

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@Cazmagic You definitely want a CT scan with contrast of the neck. This will be able to show the compression of any vascular or arterial structures. The radiologist can also turn the scand into 3D. I agree with @Isaiah_40_31 to go to someone who has treated Eagles before. Many ENT’s abide by the literature by Dr. Eagle from 1937. If you don’t have any of the symptoms that Dr. Eagle decribed than they don’t think you could have Eagles. There are a few subtypes of Eagles syndrome, Arterial being one of them. It’s VERY inportant that you see someone who’s treated Eagles. Many will require that you send in your scans prior to an appointment. You have some long styloids there!

I would definitely try to get the CT scan with contrast.

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Hi @Cazmagic,

Welcome to this nice forum though I’m sorry for the reason you’re here. When I saw your images I thought of an article I’ve posted here before:

I was thinking your processus coronoideus mandibulae might maybe look a bit suspicious, too.

Please keep in mind: I’m absolutely no expert on this but it might be worth to ask a specialized doctor about this. Would be interesting what others here might be thinking about that, too.

Hope you will find the aswers you are looking for very soon.

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