I finally received a copy of my CT with contrast and rendered it into 3D same as I did with my previous CT without contrast. Interestingly my right styloid measures 4.1 on the old CT from 2 years ago and 3.6 on the new one, but I wonder if it’s just a normal deviation or measuring error. Left styloid measures the same as before at 3.8.
I will be going over the results with my doc tomorrow but interested in the opinions of the forum members knowledgeable in reading imaging. My main complaints are severe pressure headaches and pressure/nerve pain in my face (cheeks/eyes). I suspect a vascular component and report does mention an IJV compression. But would like to know if anyone can see any other type of impingements.
“Bilateral elongated styloid processes measures 3.6 cm on the right and 3.8 cm on the left. Asymmetric narrowing of the right styloid process-C1 transverse process interval with mild to moderate compression on the proximal right internal jugular vein.”
Opinions appreciated. Wishing everyone a painless day❤️
It looks to me like both IJVs are a bit compressed by C-1/styloids. Your right styloid is very thick with a rounded tip & your left one is angled & has a very pointy tip, from what I can see. I’m sorry I can’t tell if there’s other compression.
As far as styloid measurement from a CT scan goes, the numbers given by the radiologists are rarely accurate because they don’t take into account the tiny spaces that occur between each CT slice. Those all add up enough that during surgery, the surgeons often find the styloids are longer than the measurements they were given in the radiology report. Many ES surgeons, read the scans themselves so they can remeasure to get a better idea of the accuracy of the radiology reports.
Thank you for your input, I appreciate it. I did have a f/u appointment with Dr. Hackman over the phone today and he did recommend a bilateral styloidectomy. I can’t get over the fact how easy it is to talk to him. I was asking question after question and he he didn’t seem to be bothered by any of them. I feel like if I continued asking for hours on end he’d still have no problem answering them, such a nice down to earth person. I’m now awaiting a call to schedule the surgery. I’m obviously terrified beyond words but still ready for an intervention to try and get back to normal life.
I’m so glad you’ve found Dr. Hackman easy to work with & genuinely caring. We’ve heard that a lot over the last few years. I’m glad he hasn’t lowered his standard of patient care.
