New story, seeing Dr. Merati in Seattle, needing some advice

Welcome New User Help
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Hello! I have been browsing this forum and got a ton of useful information. And it’s time I share my story as I go in my own journey.

Story

About 10 years ago when I was 24, I started to feel something behind both my eye balls. Initially I thought it’s from long screen time because I was a tech worker and played FPS video games all night, and it did disappear from time to time and came back. But eventually the sensation of foreign object stuck with me. And it went from affecting both eyes to only my right eye.

For almost 5 years, I thought it’s an eye problem, and used eye drops to try to relieve. I even went to an eye doctor who prescribed me some allergy eye drops, which obviously didn’t help.

But in the recent 5 years, the location of the sensation migrated from the back of my eyes, to the back of my nose, and eventually to my throat on the right side. In the recent 2 years, it progressed much faster, to the point that every few months it became more noticeable and more annoying.

So in 2023 I went to Bellevue ENT, did a CT scan and got a diagnosis of possible Eagle Syndrome, because my styloid process is mildly elongated. But I hesitated to consider surgery because the symptom is not that bad. But in 2025 I finally decided to go to UW medical center and I am currently with Dr. Merati.

Symptom

Globus sensation in throat on the right side

  • No pain most of the time, just annoying. I could forget that exist it if I am distracted
  • Gets better after I eat, but only temporarily for ~1 hour
  • Gets worse and painful when I get a gold, or when I am really tired at night
  • Mentally -
    • The sensation is distracting and makes me hard to focus and more easily irritated, and hard to relax so I am more exhausted
    • I often find myself hold my breath unconsciously, to attempt to get rid of the sensation

Visits

After the first visit, I tried speech therapy, which didn’t help at all. I just had my 2nd visit, and the doctor said there were 3 causes he knew of: 1) reflux from stomach (which I do have) 2) nerve damage 3) Eagle syndrome. He is not convinced it’s Eagle syndrome yet, because my left side is longer yet my problem is on the right side.

So I will try acid reducer to reduce reflux first, and then do a nerve block to reduce inflammation and see how much that helps, and move on to surgery if neither helps.

Advice needed

  1. Is there anything else I can do to determine whether the problem comes from the styloid process? I did talk to my doctor and asked for another CT scan, and still waiting to do that
  2. Is it worth doing the nerve block and other explorations, or should I just push for a surgery sooner?
  3. I also read good things about Dr. Samji in the forum. Any reasons and advantages to consider Dr. Samji instead? I guess maybe he did more surgeries and had more experience, but my doctor said it’s not a complex procedure
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@qchero thanks for sharing your story! I think you’ve come to the right place.

I suspect your styloids are irritating/compressing your facial and glossopharyngeal nerves, given the face and throat sensations you’re experiencing. Glossopharyngeal nerve is important in voice production, which could explain why you were sent to a speech therapist. Acid reflux is typically due to vagus nerve irritation which can happen between the styloid and C1.

Do you have access to your old CT imaging? Was it with contrast? I can check the level of C1 to see how much compression is occurring for you?

Also, it’s not always the length of the styloid that is a problem, it’s often the angle of the styloid or how the body navigates around it.

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Thank you! My old CT in 2023 was done with contrast. I am going to ask for the imaging when I do my new CT next week, and then post here if they still have it. My new CT is without contrast.

it’s not always the length of the styloid that is a problem

I explained that to my doctor, and that for some people the brain magically suppresses the sensation on one side and after surgery on one side they had to do the other side later - I feel I could be one of them, because I could vaguely sense something on my left side too. But I don’t think he is convinced :slight_smile:

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(duplicate post deleted)

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Hi & welcome to the site!
As @TML says, the angle can make a difference with what symptoms are or aren’t caused, & the thickness of the styloid too. & you’re right that often people do get symptoms from the opposite side after surgery for their symptomatic side- whether it’s because there’s a shift in the neck when one styloid is gone, or whether one was masking the other we don’t know, & we have had a couple of people with cross-over symptoms, where the symptoms where felt on the opposite side!
For many doctors it isn’t a complex surgery, but there are lots of cranial nerves & important blood vessels in the area- the facial nerve particularly is very delicate and easily damaged, so this puts many doctors off doing the procedure. Also if a doctor isn’t confident enough (or not that knowledgeable) to shorten the styloid as high as it’s safe to do, then the surgery might not help. We’ve had quite a few members whose styloids were shortened a bit but not enough so they still had symptoms.
So firstly it’s worth considering the risks of surgery (as with any surgery there’s risks of bleeding, or stroke, & with ES surgery there’s risks of nerve damage to the facial nerve which can cause facial paralysis, or the spinal accessory nerve which can cause shoulder or arm pain/ weakness.), and weighing that up against the symptoms you have and what effect on your quality of life they’re having. There isn’t really any definite way to tell for sure about whether the surgery will work, but the nerve block if you have one can sometimes give you an idea…
Then secondly, in choosing the right doctor there’s questions we suggest you ask in the Newbies Fuide Info section about surgery. Dr Samji has done lots of successful surgeries for members with ‘classic’ ES like it sounds as if you could have, if members have vascular ES symptoms we suggest they see one of the doctors more familiar with that. Do you know how many of these surgeries Dr Merati has done?
Here’s a link to the surgery info:
ES Information- Treatment: Surgery - Welcome / Newbies Guide to Eagle Syndrome - Living with Eagle