Hello everyone. I am new here. Thank you for welcoming me into the forum. I have been suffering for years— so many doctors, so much dismissing. I’m trying not to get my hopes up, but ES really seems to fit my symptom profile. I’m not sure about my images though. I recently posted a 3D picture of myself on Facebook. Some random person commented that my styloid process appears elongated, which is how I learned about this condition. I was wondering what you guys think of my images, but the site won’t let me post pictures. I have a consult with Dr. Annino soon. I appreciate any advice you guys have. Thanks for reading this.
Edit: I can post pictures now. Please let me know your thoughts. I’m curious if the lateral CT image with contrast shows my styloids? And if so are they abnormal?
The format of the site makes it so a new member has to post for a bit before they can upload images, I’ve had a look & hopefully it’ll work now for you
I’m not great with tech so can’t annotate images, & not the most experienced at reading the scans, but it does look as if the styloid’s elongated & on the second image it looks like there could be another section of calcification on your ligament also, and the C1 process looks like it could be a factor in potentially causing some compression too…
On the second image you can see the C1 process I believe looking quite close to the styloid process, I’m sorry I can annotate the image to show what I mean…we’ve found quite a few members have had large styloids and large C1 processes, with blood vessels and nerves compressed between them.
I can’t identify structure accurately in your first image because of interference by the soft tissue around your skull base & upper cervical vertebra, but I’ve annotated the second image. I can’t see the full styloid but only a section of it lower down. I can’t see the upper section near the skull base. The bit that I’ve labeled I noted could be calcified stylohyoid ligament instead of the actual styloid. Either one - styloid or calcified ligament can cause ES symptoms.
Here’s a brief definition of ES which may be helpful to you - Eagle Syndrome is defined as 1) elongation of the styloid process(es) OR 2) calcification of the stylohyoid ligament(s) OR 3) a combination of 1 & 2. It’s not just styloid length but also the thickness, how curved they are & the angle they’re growing that can cause symptoms. Unfortunately, the only “cure” for ES is surgical removal of the elongated styloid(s) &/or calcified stylohyoid ligaments. Some people can have compression of their internal carotid artery(ies) or internal jugular vein(s) which adds other dimensions to their ES symptoms.
Wow, thank you for taking the time to annotate and explain ES. I didn’t realize that calcification of the ligament was also ES, I thought it was just elongated styloid process.
I feel a lot more validated and comfortable now, so thank you very much. I’ve been nervous as anything waiting to consult with Dr. Annino. I’ve read his fantastic reviews from this site, but I’ve been to so many dismissive or kind-but-useless ENTs, dentists, orthodontists, neurologists, neuro-otologists, TMJ specialists, orthopedists, physical therapsists, chiropractors, massage therapists, Myofunctional therapists, etc. It’s stressful meeting new doctors, which I’m sure others here can relate.
If my issue involves calcified ligament, would Dr. Annino still be a good surgeon choice? I read one review on here yesterday from ddemaso who said they were still having issues because he only removed the middle section of the calcification.
Saw the doctor today. He said based on my scan from 2020 (which you annotated), my styloids appeared normal length but that the lower portion of my left stylohyoid ligament was calcified lower down. He said it may have changed since then, but it’s unlikely causing my symptoms. I don’t know what to do. He’s reviewing a scan I got 2 months ago and will get back to me to see how it compares, but I’m disappointed that I’m back to square one. I guess partially calcified ligaments lower down arent symptomatic?
@Simply, the doctor you saw may be wrong. Calcification anywhere along the stylohyoid ligament can cause symptoms because the calcification can tether that section of the ligament so it can’t move freely. The stylohyoid ligaments facilitate the movement of the hyoid bone so if one or both has limited action due to calcification, that can cause trouble for the hyoid which can result in pain.
