I made a post a few weeks ago describing my symptoms and included a panorex which was inconclusive – I hope it’s okay that I started a new topic rather than adding to that one. I was finally able to get get a 3d render of a CT I had done 12/2023. I think I found my styloids and they look heckin chunky to me, can folks confirm?
Thanks for looking! 
@joes - You did a fine job of converting your CT into 3D, however, your images are zoomed in super far so it’s a little hard to tell what I’m looking at on the left side. It appears you barely have a styloid on the left, but you do have a thick section of calcified ligament, if I’m looking at the right things in the image.
Are your unilateral symptoms on the right, by chance? Your right styloid is elongated, quite thick & very angled. As I recall, your symptoms are somewhat typical of internal carotid artery compression or irritation, but w/ the image being so zoomed in, I can’t really see what’s going on w/ the IJV or ICA in either image. It would also be good if you could include your hyoid bone in the images as calcification of the stylohyoid ligament from the hyoid bone up toward the styloids can also be a problem.
Thanks for the reply, Isaiah! Here are more zoomed out images:
Right
My symptoms are actually on the left, so that’s weird. My hyoid bone itself also seems like it could potentially an issue – it seems unusually “long” (front to back) and wide:
It definitely makes contact with the carotids on both sides, but maybe that’s normal? I can move it around, which can help or worsen my symptoms somewhat, but I try really hard not to because it’s an alarming “popping” sensation.
Your right side styloid does look quite thick, and longer than on the left, but the left looks very wide and as @Isaiah_40_31 says it looks like there’s some calcified ligament below it which you’ve ringed. Looking at the later image you posted, it looks like there’s not much of a gap between the calcified section & the C1 process so could potentially cause problems? In the last image I do agree that your hyoid bone does look pretty big!
Thanks, @Jules! Does it seem like there’s definitely enough here to consult with a knowledgeable doctor? I have horrible insurance and have already spent sooo much money and time chasing geese over this; I’m pretty gunshy about seeking specialist referrals anymore but if this really does seem promising I will do it.
@joes - Thank you for sending zoomed out images. @Jules & I agree about your styloids i.e. left is short but very thick w/ some ligament calcification & right is longer & also very thick.
The fact that pressing on your hyoid increases symptoms is very telling that it may have elongation of the greater horns. I’d have to see the hyoid from the side to be able to comment on that more accurately. Since your symptoms seem more carotid-oriented than jugular, with a possible connection to your hyoid bone, I’d recommend you see Dr. Cognetti in Philadelphia, •Dr David Cognetti, Thomas Jefferson University Hospital, Philadelphia 215- 955- 6760 (Has done many successful surgeries on members). Only removes ligaments if calcified. https://hospitals.jefferson.edu/find-a-doctor/c/cognetti-david-m.html as he does surgery for Hyoid Bone Syndrome as well as ES. We’ve had several members who’ve had HBS vs ES. The symptoms are very similar. Dr. Dewan in Louisiana also does hyoid bone surgeries so that’s another doctor you could check out. •Dr. Karuna Dewan, Ochsner LSU Health Shreveport - Academic Medical Center
1541 Kings Hwy, Shreveport, Louisiana, 1-318-626-0050
https://www.ochsnerlsuhs.org/doctors/karuna-dewan
Your cervical spine also is very straight, almost curved forward so has lost it’s lordotic curve. This seems to be a problem many of our members have. There are neck exercises (many YouTube videos on this topic) which you can do to regain the proper curve in your cervical spine. It can take time but some of our members have found their symptoms reduced once they started working on cervical curve restoration. Here’s a good link from our forum which @vdm wrote & should also be helpful:
Thank you (again) @Isaiah_40_31 and @Jules for looking; I can’t tell you how much I appreciate your help! It seems like y’all agree that this is worth consulting with a specialist about. I’m actually near Dr. Jeff Burry who’s on the list of doctors (and I think he even takes my garbage insurance), so I will schedule with him for a diagnostic appointment – but I will almost certainly talk with Dr. Cognetti afterward for a second opinion/surgical consult if needed.
I have a couple more shots of my hyoid I’m wondering if you could weigh in on, as a “yeah that’s pretty weird” or “no, that seems within the range of normal” or “I don’t really know about hyoids specifically” (since it’s not strictly Eagle)?
This is the best shot I could get of my hyoid “as a whole” and showing the structures the greater cornua are near.
From the back. From what I could find in a few papers talking about average measurements/shape of hyoids, mine is crazy wide left-to-right?
Finally, there is a mass I circled here on my right greater cornu. Could be an artifact/some other structure because I’m not a radiologist or anything, but it seems atypical?
Your hyoid bone does look wide to me, too, however, I haven’t done any research to see what normal/average hyoid bone width is. Since you have, I’ll trust what you say. In your top image, the greater horns look pretty close to your spine. That can be due to elongation of the greater horns, but perhaps, in your case, it’s because the width of your hyoid has made it more spread out (i.e. the curve isn’t as deep) which has brought normal length greater horns closer to the spine.
I don’t know what to say about the mass you’ve circled. The answer about that will need to come from whomever you see to discuss your styloid/hyoid situation.
Not an expert but I agree it does look pretty wide, and the greater cornu could potentially be causing irritation…I would say it’s worth exploring the styloid/ ligament calcification as well as the hyoid with an experienced doctor…
This is not meant to be offensive at all but with curiosity and concern.
I was wondering if members/participants here have medical backgrounds? I only ask because I’ve seen posts of people asking the group to look at their scans and others giving opinions. I understand no one is giving medical advice but concerned it may give false hope (as in an answer to their questionable symptoms) and/or inaccurate information. I’m a nurse and have no clue how to accurately read a scan and leave it to the professionals with myself reading the reports. It’s very difficult to know the length of anything nor the density without specific measurements (done by the specialized equipment specifically for reviewing these images) because the images themselves can be misleading without that specific information and can be different depending on which view/segment you look at. I truly do not want to offend anyone nor critic anyone’s knowledge or experience, just wanted to better understand this practice in the group.
No offence at all! We do caveat that we are not medical professionals, and just make suggestions of things members could ask their doctors about to point them (members, not doctors!) in the right direction, tying that in with what symptoms members have & seeing whether it could potentially be ES. Unfortunately unless specifically asked, many radiologists don’t mention abnormalities in scans, so sometimes we can help by making a suggestion- like if the IJVs look compressed, or if the hyoid looks a little long…we’re in no way diagnosing anyone. And the measurements with CTs aren’t very accurate we do state that. A few members have studied in great length for their own benefit so have shared that knowledge with others to help them…I’m not that knowledgeable myself so can only say a basic ‘that styloid looks a little longer or wider than average’, or that the C1 looks a bit larger than average, it’s just to give members an idea what to ask their doctors about, or otherwise to see if it’s worth them getting an image re-read by radiologists & to ask if they can look at an area in more detail…
Thank you for explaining and not seeing my question as offensive. Not my intent at all.
