@Tjmhawk01 Thanks. the feeling is mutual. Now that you told us the stretching also relieves the pain a bit makes me think swelling + fluid remnant + inflamed nerves/muscles are at least partially to blame as when you stretch, you create more room for the fluid and swollen muscle to expand a bit and perhaps temporally relieve the pressure on the nerves. It could be that you are a slow healer and the wound could be deeper. Dr. Omile incisions tend to be longer (as I have seen a few) and behind the hear hence requires longer time to heal is my assumption. I would say get the Fiesta MRI done so your anxiety knows that there is nothing sinister going on inside the skull like vascular compression. Perhaps, that will give a peace of mind and the patience to wait it out. Wishing you the best in any Scenerio.
I love all the information & advice youāve received from your recent update, @Tjmhawk01. I think @KoolDude hit the nail on the head as far as there still being some inflammation (which can occur in the form of excess lymph fluid in a small area). Iāll hope & pray that as that is reabsorbed, your angry GN nerve will settle itself & begin recovery in earnest.
You are such an encourager to others on our forum. Iām so glad weāre here to help you during your time of struggle as well! 
@Isaiah_40_31 - I desperately hope you and @KoolDude are right.
I tapered off the Gabapentin and this past Tuesday evening began Lyrica.
Friday morning I had a chat with my PCP again and she feels a Neuro will only go as far as to prescribe meds which I think is terrible. Iām not interested in masking this. I want to do what I can to make it go away but. I have an āurgent referralā through my PCP clinic but canāt get in to see a neurologist until the end of October. So my doc is going to send a referral to Mayo which I have several clinics near me and may be able to get in there sooner. She also recommended in the meantime I visit with my pain mgmt doctor but I speculate he too will only push meds.
She agreed to give me a 7 day course of no-taper prednisone as a diagnostic which I began Friday morning. Itās a toss of the coin at this point as to whatās helping. Either there was inflammation that has eased from the prednisone or I finally, after two years found a nerve med that helps. The last two days have been quite a bit better. Friday afternoon, the day I started the prednisone, my ears plugged up while driving through the hills so I popped them and immediately the pressure/fullness Iāve had in my left ear was gone and hasnāt returned. Since Saturday I still feel a static type burning orally but itās not near what it was. Just enough to remind me itās there. Also still feeling some pressure in my neck under the incision. Iām doing my best attempts at my own lymphatic massage in the meantime. Iām not sure if Iām really helping it though.
I have an early morning PT appt his Thursday and Iām hoping she can provide some help with lymphatic drainage and advise on what she thinks regarding inflammation/fluid. Later Thursday I have a call with Omlie and have jotted down a couple questions about surgery. I donāt expect heāll offer much post-op help so Iām prepared to just keep my questions related to what he did.
Lots of prayer throughout this process. Onward I shall push.
Thank you all- Iāll update again later on.
@Tjmhawk01 I know we do not have a concrete evidence but If I was to bet, I would bet on prednisone making the difference. Everyone heals differently depending on their age and robustness of their immune system which is a double edge sword. When an injury/wound occurs such as operation, our bodies respond in 2 ways. One to protect us from infection and two to repair the damaged tissues. What this means is an increased blood flow to the area of the injury since blood carries both immune cells and repair proteins which are the material needed for prevention of infection and tissue regeneration. If you hear inflammation caused by operation think of swelling and when you hear swelling think of increased fluid build-up, that is the mechanism behind swelling as fluid is pumped to the area, the nerves around the area get compressed by it. One way people feel their pain lessened if they use cold press, is they reduce the blood flow since cold constricts blood vessels (vasoconstriction) and as result, it reduces swelling by way of less fluid build up. Similarly, Steroids work by reducing blood flow similar to the cold and also reduce/block the production of chemicals that cause the inflammation in the first place. My hypothesis is, because of reduction of blood flow and other irritants into the wound, the ear fullness would reduce and swelling will also be reduced relieving the pressure on the nerves in the area such as GPN hence the small improvements of the symptoms. That is why it is hard to conclude other causes while the wound is healing. Sometimes, if your immune system is messed up, the inflammation triggered by operation or even an infection never let up and medication need to be brought to bear in order rein in the immune system response. This happens to many people. Perhaps, your immune system is in overdrive mode and mimicking the earlier compression of the Styloid bone.
BTW, I forgot to ask, did they put drainage into the wound after the operation? some doctors do it for the first 24 hours or so and some donāt. This helps the initial build-up of fluid to be drained. I am pretty sure the pressure you feel is from fluid into the muscles and in the other tissues as part of healing the process.
This all makes perfect sense and part of the reassurance Iām grateful for. I did not have a drainage tube and Iām not certain this is something Omlie routinely does as other surgeons do.
I guess knowing that Iām otherwise a very healthy person, no maintenance drugs (except for this), no other sinister/underlying conditions and I take my health seriously, maybe my expectations of recovery are perhaps very skewed. Even having had reflux surgery a year ago thinking it was the reason for my symptoms, my surgeon remarked how quickly I recovered. Though that was also laparoscopic and in my stomach, not rooting around in my neck.
Maybe my biggest reminder is to know that at this stage of recovery is not abnormal and inflammation/fluid isnāt at all uncommon? To me, it just doesnāt feel normal and this is where my doubt creeps in.
Give a prednisone a trail and see if you feel a marked difference. You are right. Your recovery is not unusual.
Thinking of you & hope the improvements youāve had keep going!
HOORAY for some positive changes. I also hope these are permanent!
I agree, once again, w/ all that @KoolDude has postulated regarding the cause of your pain & the reduction of it. I think of inflammation as the body putting a āpillowā around the injured area. It protects what is healing but in the process applies pressure to the surrounding structures which causes pain/irritation as a result. The pain, etc., serves the purpose of warning you not to use the injured area as it needs time for rest & recovery. Unfortunately, in the case of ES surgery, we canāt rest our tongues, throats, & necks because their constant use is vital to our existence so surgeries in those areas can cause inflammation that is slower to disappear & pain/other symptoms can last longer.
Hi friends-
I hope all are having a nice Sunday. Itās like fall here today in WI- cool and windy!
So last week I had a call with the surgeon to get some operative questions answered. Today I logged into MyChart to review his notes and am interested in your feedback and thoughtsā¦.and perhaps just a need to vent off a little
Most importantly during my call, I wanted to know if there was any chance the Glossopharyngial nerve couldāve been irritated during surgery. As youāll read, he suggests any work was done anteriorly to this nerve and that this nerve is quite deep, never being exposed. He suggests in his notes that itās possible the styloid/ligament couldāve been compressing the nerve but the following sentence reads that he feels itās unlikely (but possibleā¦wait what?). I feel a little deflated that someone whoās experienced, and Iām not discrediting him at all, would feel this would be unlikely. To muddy this statement even more, my consult with him back in October specifically states, quote: āOngoing discomfort and possible nerve irritation very likely related to elongated styloidā.
Iām feeling a bit uncomfortable that my symptoms havenāt seemed to be fully heard and that each statement contradicts the other. Perhaps Iām being too detailed in my care and need for answers where detailed answers canāt be provided?
Iāve been journaling my days and while my neck still feels inflamed, some days are better than others. Iām still quite uncomfortable with the burning, but I have seen a number of days peppered in that have been improved- this compared to zero improved days pre-op. Several post-op days that Iād say 5/10 or less where pre-op was easily 8-10/10 daily. Many of those days improved within the first 4-5 days of Lyrica but I have to believe it would take time for that to build in my system and wouldnāt have given me such quick results.
Certainly, I canāt possibly be wrongfully convincing myself that this is something that will more likely than not, go away with time? Iāve read far too often here that ES is a big contributor to irritation of this nerve, so maybe heās just not as experienced with classic ES? I hope you all can understand my disappointment with the inconsistencies in these notes. Idk, maybe transcript interpretation had something to do with the inconsistencies. 
A bit ambiguous! I do think that doctors are very careful to say what symptoms & what arenāt are caused by ES, because they donāt want to let people down after surgery if it doesnāt āworkā. & guessing he was being careful to avoid any potential allegation that the nerve was damaged during surgery? I would be reassured that no damage was done in surgery; I donāt know, but even if he didnāt see contact between the styloid & the GP nerve during surgery it doesnāt mean when your head was in certain positions before the op that it could have been in contact & caused inflammation? And as he says the pulling on the hyoid by calcified ligaments couldāve caused it. So it is hopeful that this symptom will go in time as the nerve healsā¦
Dr Hackman specifically told there are many symptoms that he cannot explain that seem to be related to ES. The most important thing is to remove the entire styloid correctly and then itās sort of a waiting and guessing game to see what symptoms resolve.
@Jules - I believe all youāve stated as this is, and has been very positional. Itās been far more uncomfortable while sitting and less so while moving about and even going away during sleep/lying prone.
Let me pick yours and others brain:
After my PT appt last week, the therapist referenced ligament tightness of C1-C2. This is something Ive continuously heard in one way or another over the course of 2 yrs. I had done exercises that ultimately aggravated the pain and made it worse so they were shelved and did the Chiro treatment which did nothing. Then I was diagnosed with ES and figured I was in the clear and had a concrete path.
About 8 weeks post op and Iām still feeling all the same pain albeit varying degrees. Iām beginning to wonder if thereās something going on with C1/C2 transverse process and nerve irritation. The pain I feel is right in that area and if I apply pressure in that area, it feels tender (as it did before surgery) and the burning decreases. Iām going to test this theory over the next couple days to see if itās consistent. Even that crackling noise that I thought sounded like inflammation if it had a sound is in that C1/C2 area- maybe itās actually those tight ligaments my PT spoke of? At my original head/neck CT review nearly 2 yrs ago when this all began and before finding ES, the only thing noted in findings was mild degeneration of c6/c7. Could it be that these ligaments are just āstuck/tightā due to ES?
Are you, @KoolDude or @Isaiah_40_31 able to offer any advise or thoughts on this to help guide me? Itās a stone I feel that I need to turn over and evaluate. I Simply canāt sit still and just wait it out, but this is all very foreign to me and you all are so experienced and have pretty much seen/studied/read it all.
So! I have an appt with the pain mgmt doctor who helped get my styloids reviewed and ultimately diagnosed as ES. I also anticipate in the next week ish to have an appt with a neurologist with Mayo Clinic - praise God, scheduling is only out a week or so! Just waiting for my referral. A far cry from the October appt I originally had with my clinic.
Thanks all for not only helping me, but educating me.
I think I have to agree with you that after all Dr. Omlie is not an ENT/Skull base surgeon but a vascular Surgeon according to his website (https://health.usnews.com/doctors/william-omlie-852868) so it is possible he is only very familiar with vascular Eagle where there is compression of Vein or Artery. Typically when they are operating they need to make sure that elongated styloid/ligament is not compressing any cranial nerves so his contradictory remark seems to suggest he does not know whether it was compressing it or not because he might not have checked it at all. The close proximity of GPN to the muscles/ligaments he dissects makes me suspicious of a slight tampering of the nerve, at least superficially but not deeply. He should have paid close to attention to this particular nerve which in this case it does not seem to be the case. ENT Surgeons are very familiar with cranial nerves and are not usually interested in the vascular aspect of it as is the case with Dr. Samji & others. Anyways, it might be lengthy but I expect it to recover but as is the case with cranial nerves they might take time and test your patience.
@Tjmhawk01 I really do not think this has something to do with your cervical spine. C1/C2 do not cross path with GPN from what I have seen. Tight ligament/tendons due to the surgery is possible to be compressing/irritating it when upright since ligaments have to work against gravity to hold bones and muscles together and tension is more in an upright position. When lying down, your head is resting against the bed and ligaments/tendons do not have to work against gravity as much so they might relax and as result give a temporary relief. This is all theory since we do not have any evidence. I could be wrong but I really think surgery and inflammation are still playing important part in all of this. I suggest you request a contrast CT of the neck to see if there is any left calcified ligaments that might be to blame. As I learned from other cases, this is not far off. It might even be that he did not remove calcified ligaments (remember he is vascular Surgeon) in there and if it remains, it will definitely continue to cause more pain. I am willing to help you look into it if you get one and look bit more deeply on it. May be we can find something around the surgery area. At least, we can rule out any compressing calcified elements left in there.
@Tjmhawk01 seeing the Styloid/ligament that was removed. It did not look like one whole piece and seemed broken pieces of styloid/ligament. I am wondering if all the pieces were removed or whether some were left behind? we can only know through Contrast CT.
@KoolDude & @Tjmhawk01, We have had members whose styloids āshatteredā when their surgeons tried to cut them to remove them so little bits of calcification were left in place. In at least one situation, the member had to go back for a later surgery to have fragments removed. Her surgeon did tell her post op that the āshatteringā had happened & warned her of possible future surgery.
I feel like Dr. Omlie is saying, itās unlikely surgery impacted the GN, but not impossible, so here are my thoughts about the glossopharyngeal nerve: We are each ābuiltā a bit differently, & perhaps Tjmhawkās GN isnāt situated as deep as that of some others. Even though Dr. Omlie may not have seen it, that doesnāt mean it couldnāt have been just under the surface of the area where he was working & could have been impacted by surgery. Regardless, I still believe the GN will recover more completely with time. Itās just unfortunate that itās so āfired upā at the moment, but Iām encouraged to know that the level of pain is less than before surgery & that you, @Tjmhawk are having a day here & there where the burning is reduced. That bodes well for your future recovery.
@KoolDude @Isaiah_40_31
Thank you for your feedback. I do know from my conversation with him that he indeed removes the ligament. He removes all calcified portions and said that he releases the remaining soft portion to retract. Further telling me that removing the entire ligament I full tends to add further complications in his experience. The styloid itself was removed in one piece, to the skull base and then smoothed off. So at least I can feel comfortable that this was done well. Not all specialists are created equal, indeed.
I will be visiting with my pain doc soon with hopes of finding an appropriate dose of meds to help calm my arsss down. Itās a vicious cycleā¦pain creeps in, anxiety sets off, fear of another failed surgery follows and the depression circles in for the kill. Iāve never been such a mess in my mental health as I have now dealing with chronic pain.
I have noticed Dr. Omlieās notes frequently do not reflect what Iāve told him, and are contradictory and confusing at times.
However, he seems to typically get the job done, and well, so I think following up with additional specialists regarding the other symptoms is a good idea.
Heās vascular.
Have you considered asking his - is it nephew? - the one who assists with his procedures? He might have additional thoughts.
@Tjmhawk01 While that is true and most of them say they remove all of the ligaments and Styloids, we are seeing evidence contrary to the claim that all calcified ligaments are removed (fragmentation can happen and pieces of calcified ligaments could remain with/without their knowledge). I can only believe it if post-surgery CT scan shows that is the case. It is even important when you are dealing with residual pain from the surgery.