@MisterFrodo are you able to go into your CT imaging, go to the axial view and go to C1? I’ve attached my own imaging to help you know what to look for. I just want to get a top-down visual of your IJV compression and your styloid-C1 space.
Sorry to hear that did he say specifically that he had patients in the same predicament and are worse after surgery or is it just a theory ?
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Who advised you to stay away from surgery? I don’t think Dr. Hackman offers this advice himself.
To also answer @CristianSerious - There is a debate among doctors & patients as to whether or not styloidectomies impact those who have CCI/hEDS negatively. The surgeons most experienced w/ vascular ES w/ IJV compression don’t think stydloidectomies have a negative impact for the reasons that @TML mentioned i.e. elongated styloids & associated vascular compression can cause postural compensations that make symptoms worse & reduce the strength in critical postural muscles thus contributing to CCI. The stylo-hyoid ligaments play a very minor role in swallowing & perhaps speaking, but they don’t contribute to neck stability. We have a number of small muscles + the SCMs in our necks that are responsible for neck stabilization, as @TML also noted. He also made a good point about the vagus nerve’s relationship to POTS & how the vagus is easily compromised in cases of styloid elongation by its location between the styloid & C1 soon after it exits the skull.
@MisterFrodo, I’m glad if you’re having success in managing your symptoms w/o having surgery, but as @TML said, if your symptoms continue unabated, it would be good to consider surgery w/ this updated information in mind.
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The only way I could see that styloids help with CCI is if they were always directly in contact with them, and thus not allowing C1 to move any further forward. But this is almost never the case. It is very rare we see direct contact of the styloids with C1. I’ve only seen it a couple times in this forum, and it’s almost always unilateral.
Most often there is some space. If anything, I’d imagine that in situations where there are really tight quarters, looking down and chin tucks could cause the styloids to put pressure backwards and C1 and maybe can cause instability from constantly putting pressure on the upper cervical ligaments. I really don’t see a world in which styloids stabilize anything, other than perhaps the hyoid bone via the stylohyoid ligament. But even then, you have like 10 muscles stabilizing the hyoid and so the ligament wouldn’t add much.
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