HELPP, I have my phone appointment on Monday with my neurosurgeon prior to scheduling surgery and I need to know which questions to ask !? Here is my report to base it off of ! I have 24/7 drunk off balance feeling , head pressure , dizzy brain fog , some pots like heart palpitations .
I’m new to all of this and really don’t know much about it so I need to know what to ask. I’m most comcerned about getting rid off this off balance dizziness . The radiologist said my styloids are 5cm he thinks that’s compressing
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I have same feeling always like drunk guy…unable to concentrate,brain fog.What’s your styloid size btw
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5cm ! What’s your diagnosis so far ? I really hope this dizziness is coming from the styloid compression so it can go away after removal
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As you have bilateral IJV compression, and symptoms of this, then it’s important for you to get the styloids removed as far back to the skull base as possible- it’s unusual that you’re getting compression at C2-C3 level, your styloids are pretty long! Usually there’s compression at C1 level, hopefully if they can take the styloids back higher than C2 the compression will be removed. Here’s a list of questions we suggest that people ask:
- How many ES surgeries have they done and what was the success rate?
- Whether they’re going to operate externally, or intraoral- through the mouth. Whilst some members have had successful surgeries with intraoral, external is better for seeing all the structures, to be able to remove more of the styloids, & also there’s less chance of infection.
- You need to ask how much of the styloid he’ll remove- as much as possible is best- & anything left needs to be smoothed off. The piece needs to be removed too- some doctors have snapped it off & left it in! If the styloid is only shortened a bit it can still cause symptoms.
- If your stylohyoid ligaments are calcified, then any calcified section needs to be removed too.
- There’s usually swelling after surgery; you could ask if a drain’s put in to reduce swelling, or if steroids are prescribed. It’s not essential, but can help with recovery a bit.
- Will it be a day case surgery or will you need to stay in?
- Obviously ask the risks- we know from experience on here that temporary damage to the facial nerve is quite common, and also the hypoglossal nerve and the accessory nerve. These usually recovery very quickly but in some cases members have needed physiotherapy. There is also the risk of catching a blood vessel or having a stroke, but these are very rare.
- Ask if the surgeon monitors the nerves- this should be done to see if there’s stress on the nerves to avoid damage as mentioned above.
- What painkillers will be prescribed afterwards.
- Ask about recovery- most doctors either down play it or are genuinely unaware of how long the recovery can take!
- We have heard that occasionally doctors use surgical clips which are left in, it’s been suggested that these could interfere with chiropractic adjustments if needed post-surgery, so something to consider, and also we have now seen members who’ve been left in pain from the clips and needed further surgery to remove them, so do ask if they might be used.
In addition, as you have IJV compression, I would ask if they will check to see if your IJVs are flowing better, and also check to see if anything else in that area is causing compression- it could also be caused by the cervical vertebrae processes, by other blood vessels, fascia, nerves or by muscles, & if there is anything else, what can be done, will they do something about this ? (For example some doctors remove a portion of the digastric muscle if this is causing compression). If you’re having one side removed first, then as your left side IJV is the dominant side, you would probably benefit most from getting this side removed first.
I hope this helps, & let us know how you get on!
Eagle syndrome styloid measuring 42mm.Cervical spine exercises like chin tucks given me relief as my Cervical spine curve become straight.These exercises reduces my 50% of brain fog.
@Sabrinab when the radiologist says “complete occlusion at c2-3” with the head movements, that doesn’t necessarily mean it’s due to the styloids (even though you have eagle syndrome, obviously). At the C2 level the posterior digastric can cause IJV compression, which would also occur with head movement. It’s possible it’s your styloids but I don’t think I’ve ever seen IJV compression from the styloids at that level (due to the typical angle of a styloid, and the typical trajectory of the IJVs). Hopefully it is just your styloids causing the compression (rather than soft tissues) and that styloidectomies will open them up. I definitely think it is worth getting them cut above C1 though. I would find it hard to believe that they aren’t compressing at the level at C1 but are at C2-3.
Do you have CT imaging on hand? I can help you see the compression and I can see what structures are causing it
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Chin tucks can help some members but it also can be quite risky for others with IJV compression, so I would caution anyone with this not to do chin tucks if it makes symptoms worse…
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I agree with @Jules in that chin tucks can make things worse when there is IJV compression by styloids.
@madhavshrma if I remember correctly, you have hyoid bone issues, and it’s more likely the chin tucks are moving your carotids away from your greater horns rather than opening up your IJVs I would think.
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Yes only for few minutes it help then again back to bad state
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@Sabrinab - You’re seeing Dr. Jian, correct? I think it’s important for you to discuss the possibility of your posterior digastric muscle causing IJV compression at C2-3 as @TML suggested, & ask him how he would deal with that during surgery. We know of one vascular ES surgeon who removes the posterior digastric muscle(s) in all his patients who have IJV compression along w/ doing a C1 shave as he feels this gives the best long term results for his patients.
Every doctor has his/her own surgical technique, but it’s a good idea to discuss everything from the position you’ll be placed in during surgery to what will be removed from your body (i.e. styloids - how short?, TP of C1, muscle, lymph nodes, other insignificant vascular tissues, etc) & what will be left behind (i.e. uncalcified stylohyoid ligaments, stub of styloid, surgical clips - if used). Besides the questions @Jules listed above, if you have any concerns or fears, make them known when you have your appointment.
Please let us know what your surgery date is when you get one.
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I met a resident doctor who told me styloidectomy leads to more clacification of liagement in near future…i guess he told me there is a ligament near to styloid that will grow or maybe styloid process?is it correct @Jules @Isaiah_40_31
No, he’s wrong! When the styloid process is shortened, it can occasionally grow back, but this only rarely happens. When the styloid process is removed, the ligaments which are attached to this are stripped from it, and either left in if they’re not calcified as well, or if they are calcified then they should be removed. If the surgery lead to more calcification in the near future, then we would see lots of members needing more surgery, which doesn’t often happen- it’s been 10 years since my surgery, I haven’t had any regrowth or new calcifications.
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Lol Indian doctors
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