I was diagnosed with Eagle Syndrome by our local otolaryngologist with ENT clinic. On my first visit with the doctor I shared with him my symptoms. He shared he didn’t think I had Eagle Syndrome but thought I may have Hyoid Syndrome, which he said is similar to Eagle Syndrome. He ordered a CT scan with contrast which I had on Oct. 24, 2025. I asked at that time if it was going to be a 2D scan or 3D scan. He said he did not need a 3D scan. On my follow up visit with the doctor after having the CT scan, he shared with me I had both Eagle Syndrome and Hyoid syndrome. He gave me a steroid shot in my neck. We did not discuss surgery. He said I had a calcified styloid process on the right side, and a calcified stylohyoid ligament on the left side. If I can figure out how to attach my CT scan images to this post, I would appreciate any input on anyone pointing out where they see my calcified styloid process and stylohyoid ligament, and if they are long. The first is a picture I took of my image the doctor showed to me, but with little explanation. The remaining images, my left and right sides, and the back of head are the 2D images of my CT scan which I converted to a 3D image. Thank you for your input!!!
I’m sorry I’m not able to label your images for you…Your styloid processes do look longer than average, they’re quite thin & pointy.. Your hyoid bone processes look again a bit long, thin and pointy, I can’t see any other calcifications on the stylo-hyoid ligaments , when the doctor said you have a calcified ligament on the left it could be that the styloid is more elongated than the right, or there could be a section of calcified ligament joined on to it, it doesn’t really matter, it’s longer than it should be!
I don’t know what your symptoms are, hyoid bone syndrome tends to cause the feeling of something stuck in the throat as well as this being common with ES, and also strangulated feelings, or clicking in the throat. It’s unfortunately not always easy to tell what’s causing what…but certainly worth seeing perhaps someone with more experience?
Thank you so much for your input! I have an appointment on April 16 with another ENT and hope he has experience with ES. In addition, I plan to get another appointment with the otolaryngologist who made my ES diagnosis and ask for more clarification on his ES diagnosis. I just read about venograms on here and now wonder if that is another thing to consider. When I had my mild stroke July 2024, it was then I was told tests revealed I also had previously had a heart attack! Unfortunately, I don’t recall having a typical, painful chest heart attack. What I do recall is in February of 2024 is having, in the middle of the night, what felt like a severe case of acid reflux that I could not resolve, which kept coming and going most of the night. A couple of hours after I got up, the left side of my neck began hurting and continued for awhile. It was after this episode that 5 months later, I had my mild stroke in which only my left arm was affected which came back to normal within a day’s time. On March 5, my excellent NP with my heart doctor confirmed my having had a previous heart attack, because the EKG they did on me a few minutes before she came in, revealed my heart attack was on the back side of my heart. She said if it had been on the front side of my heart, it would have been more severe. In addition, just this past March 21, I had another episode at 3:00 a.m., of my blood pressure getting high in the middle of the night, 148/85, pulse 100. I was having these, in the middle of the night episodes of high blood pressure, quite frequently before my mild stroke. So after reading about venograms here on the forum, I wonder if my ES is the vascular Eagle Syndrome type. I think it might be worth my time to ask my heart doctor for a venogram. I apologize for such a long post!! I want so much to “connect the dots” in these health issues I have been having. Again, thank you and the others for being here for us!! You guys are so much appreciated!!
Please never apologize for a long post. Sometimes it takes a lot of words to share information or ask questions. You did a very nice job making your 3D images. 
If you get testing done, what you want is an angiogram not a venogram. The symptoms you’ve had are more likely related to your carotid artery(ies) than your jugular veins. A venogram looks specifically at the veins & ignores the arteries. Sometimes an angiogram includes both arteries & veins so you could request that to be done. You should ask for the angiogram to be done dynamically i.e. with your head turned L/R & looking up/down as that will give the most thorough results.
The severe case of acid reflux during the middle of the night was most likely the heart attack you experienced. They can occur w/o chest pain. I know of someone else who had a severe heart attack & the only symptom was a feeling of severe indigestion prior to the event.
A stroke would also more likely be related to something going on with your carotid arteries since blood flows into the brain via the carotids. That’s the most simple way for clots to end up in the brain. The carotids can suffer irritation or compression by elongated styloids or from the greater horns of the hyoid bone being too long & poking them. From what I can see of your hyoid’s greater horns, they don’t look that long, but I agree w/ @Jules they are pointed. I also don’t see any stylohyoid ligament calcification beyond what’s attached to your styloids making them elongated. Since your image looks to have been done w/o contrast, I can’t see any veins or arteries to comment on.
Below are 3 of your images annotated. Please let me know if you have questions.
< @Isaiah_40_31 I absolutely have no words to express the extreme gratitude I have for the information you shared with me and for your annotations on my images!!! Your information has gotten me closer to “connecting the dots” I have been searching for in order to make my decision on what my next step should be. I was so overwhelmed with gratitude I broke down and cried! Thank you again!!! Armed with the information you shared with me, I plan to ask my heart care NP if I could have the angiogram as you described, looking left and right and up and down. Question: is this angiogram a CT scan with contrast? I learned from the forum about the software to convert my 2D images to 3D images, and used RadiAnt DISCOM Viewer 2025.2 (64-bit). I am attaching to this post the color images that show veins and arteries which appeared when I selected the 3D Preset button in top menu. I would appreciate so much if you could, when you have the time, share with me your opinion of how my calcified styloid process, the stylohyoid ligament, and hyoid bone would possibly interact with surrounding veins and arteries.
Comments on two images: On the front image, I have no idea what the black spot is? There is no pain that comes from that area. However, that is not true on the image of my left side where it shows an area above the ear that looks strange. I hope it is an artery and not a worm!! As I I’m driving on my way to work one morning, I suddenly felt a feeling like a major, large, strong burst of something in that area. I can’t really find the words to describe the sensation I felt. It wasn’t necessarily painful. Maybe like an electrical charge?? I found a spot to pull my car over over and stopped to make sure nothing else was going to happened and it was safe for me to continue driving. I did not have any further sensation from that area that day, but since then I continue to have pain from that area that comes and goes. It is not a headache type of pain. I have noticed the pain seems to be occurring more frequently. I can’t recall the date this happened, but I know it was before I retired. I retired from teaching in 2015, and have been dealing with this head sensation for over 11 years!
In case someone else reading this wants to have more info on using the RediAnt viewer software to convert their 2D image to a 3D image, the following is a description of what I learned while figuring out how to use RediAnt to get my 3D image. I, by no means, understand how to use all that is available to use in RediAnt, but just what I needed to convert my images to 3D.
Comments about using the RediAnt DISCOM Viewer Software after downloading and installing the trial version from https://www.radiantviewer.com It works with Windows 11/10/8.1/8/7
I used the 14-day free trial but it comes with the option of purchasing. It allows you to use the trial in sessions of 30 minutes at a time. You can go back to using it after a short time lapse. The “Next” button counts down 15 seconds when you open it after the first time. I placed my image DVD in the DVD drive (Note: the hospital Radiology Department gave me this image DVD when I went and asked them for it. They did not charge me for the DVD.) When I opened up the RediAnt software and clicked on the button that had a disc image on it, a side table appeared which displayed the images on the DVD. All I had to do was click on the image, then the 3D menu bar appears at the top, giving you more options to manipulate your 3D image. The 3D rotate button allowed you to choose anterior (front), posterior (back), left, right, superior (top) or inferior (bottom). With the 3D Preset button you could choose color Angio that displayed the veins and arteries, or black & white or other options like skin, bones, etc. Hope this helps someone save time and frustration in learning how to convert a 2D image to a 3D image using RediAnt DISCOM Viewer. It is fantastic software!!
I forgot to post my color images showing veins and arteries which I referred to in my last post. Here they are now.
Well done with the imaging! I’m sorry to read that you’ve had a heart attack and a mild stroke- I agree with @Isaiah_40_31 that it would be helpful to have a CT angiogram to look at the carotid arteries as if this was related to VES it’s more likely to be the arteries rather than the veins, although very rarely IJV compression can cause small clots. The new imaging you’ve posted does show the right IJV but I can’t see clearly the area around the styloid to see if there is any compression. I can’t see any IJV on the left side though, often people have a dominant and a non-dominant (hypoplastic) one, & I think we’ve had at least one member who was missing one IJV!
I would presume that the black area on the front view is an artefact?! You mention a black area above the left ear, again that could be an artefact or otherwise possibly mastoiditis, but I’ve never seen it show up on the outside like that- sometimes it shows on the axial views inside the mastoid bone. So I could be completely wrong, but I would ask about that!
If you have another ENT appointment, perhaps it’s worth ringing ahead to see if they are aware of ES to save wasting your time?
Thank you for your input! I appreciate your reminder about calling the upcoming ENT about checking their experience with ES. When they contacted me about making the appointment, I asked if the doctor has worked with individuals with ES. The reply was "I don’t know ", which makes your timely suggestion very important for me to check on this issue, especially since it is about a 2 hour drive to get to the appointment (April 16).
I am beginning to feel like “time is of the essence” in getting the answers I need in order to find the right doctor to get a resolve to ES. I am so afraid another heart attack or stroke will happen again before this can be fixed. For instance, I keep having symptoms of waking up in the middle of the night, due to chest discomfort, brought on by high blood pressure. I keep my blood pressure machine beside my bed because of this. It happened again about a week ago (Sat., March 21, 2026) at 2:42 a.m. My blood pressure was145/85, pulse 100. This high blood pressure like this never shows up when they check my blood pressure at the doctor’s office!! In addition, this last Friday, while I am on my 11th lap walking around the gym at the YMCA, I get another sharp chest pain. I continued to walk four more laps without any more chest pains. These chest pains come without any warning and while I am doing different things. These are symptoms I was having before my stroke on July 2024. I just now recalled, while I was sitting in my recliner that July in 2024, when I had my stroke, that I had turned to the right and reached down to grab my small puppy, and it was then, after I had my puppy in my lap, that I noticed my left hand wasn’t feeling right when I tried to pet her, then I raised my left arm up, and it would flop back down, I couldn’t hold my arm up. It was then my husband drove to the hospital. Tests revealed a blockage on the upper right side of my head. So now, in looking back, I am now wondering if my turning to the right, activated an issue with ES that caused my stroke.
Thank you again for your wonderful help and support as I take this journey to find some resolve to having ES! You guys are so much appreciated!!
@geppard - Thank you for the simple step-by-step explanation you gave about using the RadiAnt Dicom Viewer program. Much appreciated!
I’m glad what I said was helpful!
An angiogram is either a CTA w/ contrast or a catheter angiogram which is done in the hospital under light or full anesthesia, in most cases. If you get a CTA, you could also request a CTV to be done in the same session that way all your major neck vessels would be covered. We’ve had a few members with both jugular & carotid compressions & with your symptoms, though they seem more carotid related, it would be good to see what your jugulars look like as well.
Nerves can cause what feel like electrical shocks or vibrations when they’re irritated or being compressed so it’s possible that you have a nerve in that area that is suffering compression or being rubbed or poked by something. It’s odd that the spot on your imaging almost looks like it’s been burned. When I zoom in, it almost appears there’s a small hole in your skull within the dark spot. That’s not meant to scare you, & as @Jules said, it could just be an artifact in the imaging, but definitely worth asking a doctor about.
Your right IJV is HUGE & dominant. I could barely see your left one, so it’s either suffering from being very compressed, or it’s quite diminuitive/hypoplastic as @Jules noted. Your left carotid is visible in one image but not your right one, & it also looks small to me but that could be a natural variation. I wish I could have seen more of your carotids so I could try to guess what might be affecting them. These don’t always show up w/o some tweaking of the imaging in the 3D conversions.
In the image from the back, it looks to me like your right IJV is being at least somewhat squashed between the right TP of C1 & your right styloid.
The annotations on the other pictures are pretty self-explanatory, but please ask if you have questions.
Hello! May I please have your input on the following? I have been diagnosed with ES and I have not been told if it is “Classic ES” or “Vascular ES”. Because of this and since I have had a “silent” heart attack in Feb 2024 (I didn’t even know I had a heart attack because it came across as SEVERE acid reflux.), and I had a stroke 5 months later in July 2024, I need to know if it is “Classic ES” or “Vascular ES”. It was not until after I had my “Silent” heart attack and my stroke that I was diagnosed with ES in Oct. 2025. I was diagnosed of having ES by an ENT otolaryngologist, but was not told at that time if I had “Classic ES” or “Vascular ES”. He had me do a 2D CT scan instead of a 3D CT scan of my neck area because he said “I don’t need a 3D CT scan to make a diagnosis of ES”. This doctor, who made my ES diagnosis, is associated with a different medical system than the medical system I use to see my Primary Care Physician, heart doctor, etc. My Primary Care Physician has already scheduled me for a second opinion (on April 16, 2025) with an ENT otolaryngologist, that I have not seen before, and is associated with my current medical system. I have placed the 2D CT scan images in my current medical records with the medical system I use, which will allow the upcoming visit with the second ENT to see. However, because these images are 2D instead of 3D and because of the previous heart attack AND then 5 months later having had a stroke, I thought maybe the images in my current medical records would provide a more accurate diagnosis of either “Classic ES” or “Vascular ES” if the images were in the 3D format. With that in mind, I recently sent my request for a 3D CT scan with contrast of my neck area to my NP at the heart doctor’s on March 5, 2026. She is very good and I like her. It appears my thinking was “off track” in sending my request for a 3D CT scan to her because she essentially said “We do not do that in cardiology.” I now plan to make my request to my PCP for the new 3D scans. In addition, because my April 16 appointment is a 1.5 hours’ drive for me, I would like “to cut the chase” and have my 3D CT scan of neck area already completed before I go. Because my original ES diagnosis was made in 2D and not 3D, and was not made with my head turned left/right or up/down, I feel having a 3D CT scan would provide a more accurate diagnosis. All of this is to ask the following question. If my request for the new 3D CT scan (with contrast and with my head turned in the appropriate directions), is not approved, do you think my converted 3D CT scans are good enough to make a diagnosis of “Vascular ES”, if that is the kind of ES I have? I so much appreciate yours and @Jules help in my journey with ES! Thank you again!!!
P.S. On March 17, 2026, because I have trouble swallowing, my PCP ordered a swallow test. The results revealed I have a “Zenker’s diverticulum”. Do you know if Eagle Syndrome contributes to the development of Zenker’s diverticulum and/or if others with Eagle Syndrome have been diagnosed with having Zenker’s diverticulum? Thank you so much for your help!!!
If you’re not able to get another CT with contrast done, I would think that the imaging you’ve posted on here should be enough for an experienced doctor to see areas of concern, yes. And if they’re dismissive then I’d say they’re not the right doctor! What might be worth doing though is (if the ENT you’re seeing later this month isn’t on our list) ringing their office before your appointment to check that they are aware of ES, as many doctors don’t, and if you’ve got a bit of a trip you don’t want to waste your time…
There have only been a couple of mentions of members being diagnosed with Zenker’s diverticulum, as this obviously causes difficulty swallowing, it would be hard to know if your issues are just caused by this or if ES is playing a part as well, and whether is linked to ES I don’t know…
Thank you for your input!! This is appreciated so much!!
@geppard - a 3D CT scan is the same a 2D CT scan it’s just how it’s processed through the computer that makes CT images into 3D. The way the scan is done is no different.
I agree w/ @Jules that the imaging you have right now is just fine for diagnosing your situation. You really don’t need more imaging. Actually, doctors can see a situation more accurately by rotating through the axial slices of a CT scan than they can via a 3D image. We prefer 3D images because they give the whole picture which gives us an overall idea what the individual CT slices are showing.
Thank you for sharing this information! Question. My 2D CT scan did not have me looking up/down, or my head turned left/right. Is this omission any concern in trying to determine if I have “Vascular” ES?
Thank you so much for your help!
With the heart & stroke type symptoms you’ve had, I would suggest you get a dynamic CTA if you’re going to have another scan. To be thorough you could request a dynamic CTA/CTV but it can be hard to find a radiology who knows how to do a CTV & who is willing to do a dynamic CT of any sort. If you have access to someplace that would do a dynamic CTA/CTV, it could make the vascular aspect of your diagnosis more clear. Before you work on getting that imaging, though, I think you should ask whomever you’re seeing for ES to go through your current images w/ you & explain what he sees to you. You can pointedly ask if any IJV & ICA/ECA (internal/external carotid arteries) &/or common carotid artery compression is visible.
Thank you, again, for your valuable input! I have tremendous gratitude for the time and the effort you guys take to help those of us seeking answers about symptoms and treatments with ES.
We’re happy to be here for you, @geppard! 