New member - Looking for advice & Panorex interpretation

General
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Hi folks, I just joined this group last week after visiting a TMJ dentist and getting a panorex. Let me give a brief history:

  • I am a 25 year old female living in Ontario, Canada. I have struggled with anxiety and depression for ~5-6 years and have been on different combinations of SSRIs (including SSRIs (escitalopram 10–20 mg, sertraline 50 mg), an NDRI (bupropion 150 mg), and a NaSSA (mirtazapine 15 mg)

  • For at least 4-5 years, I have had pretty bad neck and back tension. I work a desk job, so I always attributed it to bad posture, sedentary lifestyle, etc., thinking I just had a poor reaction to my lifestyle choices. I’m also a vegetarian, so I’ve had low iron for a while. I take iron supplements 2x per day.

  • Over the past 4-5 years, I’ve tried massage, exercise, acupuncture, physiotherapy, chiropractor, tai chi, psychotherapy, medication, meditation, yoga, etc. Nothing really improves the symptoms. When I went to a physio and chiro , they told me I have forward head posture, an anterior pelvic tilt, weak deep back flexors, and upper cross syndrome. I blamed most of my symptoms on those, but couldn’t understand why others with similarly bad posture weren’t feeling as much pain as me. I also went to the dentist in 2023 and asked if they saw signs of grinding in my teeth to see if I needed a mouth guard, and they said they didn’t see anything. Also I told them I get tonsil stones here and there, and they said that’s normal. They also took a panorex, but it doesn’t show the left TMJ:

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  • In the past ~3 years, I’ve developed jaw, throat/hyoid tension that has become really unbearable, and would not resolve with any of the things I tried above. I decided it’s about time to go to a TMJ dentist, so I went this past week. He did a full history, evaluation, and panorex. In the panorex, he said my stylohyoid ligament was a little long, but not super extreme. He mentioned Eagle Syndrome, but didn’t formally diagnose. My TMJ looked and behaved normal. He also saw signs of clenching in my mouth. He said because the SSRIs were prescribed around the same time as my pain started, he believes that the SSRIs cause my somatic tension. He recommended botox for TMJ and appliance therapy.

  • Since then, I found this group and have been thinking more about Eagle Syndrome as a possible cause for all of my symptoms. I was hoping someone could take a look at my panorex to help figure out if this could be the case.

    Gupta, Anvita 20_JANUARY_2026 Dr Khan
    Gupta, Anvita 20_JANUARY_2026 Dr Khan1920×975 212 KB

  • Also not sure where this fits in, or if its relevant, but I had my wisdom teeth removed in 2018.

  • From the forums, I’ve seen that surgery to remove the is the only permanent solution… is this true? If so, I’m a bit scared :frowning: I watched videos of the styloidectomy surgery online and got super freaked out lol…

Looking for support, advice, or direction! Thanks in advance <3

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Hi again,

It won’t let me upload any media… here’s the error message I’m getting:

“An error occurred: Sorry, you can’t embed media items in a post.”

Thanks!

UPDATE: pictures have been added to the main post :slight_smile:

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@alfalfagrains - Welcome to our forum. The symptoms you’ve described in conjunction with having had a somewhat elongated styloid pointed out in your panoramic x-ray sure sound like you have ES. Unfortunately, too many doctors aren’t aware of the multitude of symptoms an elongated styloid, & even one of normal length can cause, depending on its thickness, angle of growth, how curved, twisted, or pointed it is, & whether it has its own outgrowths or other features making it irregularly shaped.

Your struggle w/ depression could be related to your vagus nerve being irritated by your elongated styloid as it’s one of the cranial nerves that is most frequently affected by ES. It is the largest of our cranial nerves & affects/directs many of our bodies functions. Anxiety levels are among those.

Getting tonsil stones, even on an intermittent basis, isn’t normal so there is that to consider as well, though we don’t specifically know what causes them.

Working on improving your posture will potentially help reduce your symptoms. Here’s a link to a post with lots of information about how to do that:

ES surgery does look scary on YouTube videos, & it is considered major surgery, but choosing a very experienced ES surgeon goes far toward producing a good outcome. I had two surgeries (one for each side) in 2014/15 & was very thankful to get back to a more normal life once I was healed.

I look forward to seeing your Panorex when you post it.

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New members often have to post a bit before they can upload images, so hopefully you can now…
It is worth looking at the link @Isaiah_40_31 gave you as we’ve had members find that even a pelvic misalignment can have a sort of chain reaction up the whole spine… But I would say that calcified stylo-hyoid ligaments or elongated styloids aren’t very obvious to most radiologists and other medical professionals & ES is often over looked as a diagnosis, so if yours were remarked on then it quite likely is significant! We also see members who have elongated hyoid bone processes too, which can cause similar symptoms… So it would be a good idea if you’re able to get a CT scan (from the base of the skull down to the hyoid bone) as this is the best way to see the styloids & hyoid bone.
Best not to watch the surgery if you’re squeamish, but for most of us having the surgery is worth it to get the symptoms resolved. And usually recovery isn’t as bad as you’d think.

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