Hi all, I had surgery 2.5 weeks ago, not on my styloids but to resection the hyoid bone/trim both back ends and trim down the thyroid cartilage horns. The recovery has been fine/easy mostly, although my swallowing symptoms which the surgery was for, haven’t really improved. I won’t go into too much detail on that as I don’t think the surgery was a failure and don’t want to put people off, it’s just the bits I need cut away, to allow my swallow to move as it should, have not been cut, so only part of the job has been done if that makes sense.
The reason for my post is, since the surgery, and I appreciate there may still some inflammation, I have this pain which seems to stem from the back of the throat, roughly roof of the mouth height, slightly to the right of centre. It’s not there in neutral position but if I am in say a chin tuck like position or if I yawn, it is extremely painful, as if there is a pressure/poking in that area.
I’m not too concerned, it’s early days and things may settle but generally all the swelling has gone and I feel back to baseline. So I’m just wondering what this is, as technically I didn’t have surgery in that area. Where the pain is coming from is slightly higher up and further back than where I had surgery. I’m wondering if it’s my styloid but then why would that have raised it’s head when I didn’t have this symptom before and the surgery was not on that area.
I’m glad that you were able to find a doctor to do your surgery, and as you say it is early days in your healing so it could be inflammation causing the pain. I wonder if maybe it’s an internal stitch causing pain as the tissues heal; I’m not sure how the surgery was done, but I’d guess there must be some internal stitches?
Otherwise it could be the Glossopharyngeal nerve which could’ve been irritated during the surgery? The pain sounds as if it could be that? @Isaiah_40_31 has posted about Two Minute Neuroscience videos on YouTube which explain the paths of the cranial nerves, might be worth having a look at the one for the GPN, and see if that’s the area of your pain?
Will you have a 6 week check up with your surgeon?
I hope that as you heal this issue will settle & the problems you have with swallowing
@Callmestar1 - You’ve had quite the journey to finally getting to surgery. I’m glad to know what you’ve had done! You’re right when you noted you likely still have some inflammation. The external appearance of swelling can disappear a while before the internal swelling fully recovers & that internal swelling can press on nerves & bring up symptoms that you didn’t have prior to surgery. I understand that can raise questions & concerns. I awoke from my first ES surgery w/ a half paralyzed tongue. Though I had tongue symptoms prior to my surgery, paralysis wasn’t one of them. It was because my glossopharyngeal nerve was wrapped around my styloid & had to be moved off of it which caused major nerve irritation. It took about 9 mos for my tongue function to return to normal. That’s just to say that what you’re feeling in your through & roof of your mouth is hopefully temporary & will fade as time passes. I also hope that your swallowing problem resolves as your recovery progresses.
HI Isaiah, yes a long journey to get here and unfortunately the surgery hasn’t resolved the issue. Again I will wait for inflammation to reduce but I can feel the thyroid cartilage is still stuck/caught, 100% at the thyroid lamina, which wasn’t trimmed even though I asked for that, and perhaps still jammed elsewhere. But yes I do hear you re the internal swelling.
I can empathise with your tongue, albeit I didn’t have it to that degree but mine wasn’t able to move to it’s normal range at first, that seems to be pretty much back to normal now. I have a numb patch from chin to incision line at the adams apple, which doesn’t bother me much and maybe might resolve, maybe not, we’ll see.
I’m now considering getting the right styloid out, or even both. Styloid issues and CCI are the only real vague diagnoses I have to go on and styloid removal is obviously less invasive than cervical fusion so maybe that’s the next step. My styloids are not super long, although are partially calcified and i’m in a constant struggle with head pressure, lightheadedness, throat/neck discomfort/tension and all sorts of other symptoms. My right ear also always feels half blocked so i’m thinking besides the normal surgery risks are there many downsides to getting styloid removal in my situation?
I’m really sorry that your thyroid cartilage surgery didn’t provide the results you hoped for, but in time, your current symptoms may reduce.
As far as the styloidectomies go, I don’t see any downsides other than the normal surgery risks. Getting the right side shortened may help w/ the plugged feeling in your ear & help reduce the vascular symptoms you have if the styloid is playing a role in that. As you likely have read, IJV compression & even ICA compression can be caused by nerves, scar tissue, muscle. In the case of the IJV, bony compression caused by the styloid &/or styloid & the transverse process of C1 in the case of the IJV is also common. We have seen some cases where both styloids need to be resected & both IJVs decompressed to allow full recovery from vascular outflow obstruction.
Please keep us updated about your current recovery & what you decide about having a styloidectomy.
Yes, my right IJV and TS are invisible on MRV so it looks like there is little to no blood flow through there. Not sure if from compression or from another cause. I may get a CTV but i’ve had so many CTs/X-rays at this point!
I hope there are no downsides per say to getting the styloid removed and also the stylohyoid ligament. But there’s some debate as to if it impacts/worsens instablity/CCI which some neurosurgeons have diagnosed me with. But naturally i’d want to try getting styloids about before even considering a fusion.
I don’t think there’s a consistent answer as to whether CCI is worsened w/ ES surgery. Some people diagnosed w/ CCI get good results from their styloidectomies whereas others have commented their symptoms were worse afterward. I will say from my experience, having my styloids & stylohyoid ligaments removed was a good choice, but I don’t have CCI so am comparing apples to oranges by giving my opinion.
Thanks. So you had the stylohyoid ligaments taken as well. That’s what i’m thinking about doing. Did you notice anything in terms of your swallowing change or any hyoid bone issues after the surgery? Seeing as the ligament is attached to the hyoid.
I had a swallowing issue as one of my ES symptoms, & it did improve after surgery, but not 100%. I was told by my surgeon the s-h ligaments play a very minor role in swallowing but since my swallowing actually improved post op, I suspect it was more nerve related. I haven’t missed my ligaments.
Still have this symptom. It’s actually both left and right of centre, extreme sharp pain when yawning. Depending on what position I’m in, I feel it more on one side than the other. Typically worse on the right. Again, it’s roughly roof of mouth height, toward the back of the throat, and radiates from there. I’d describe it as in line with either side edge of my nose/nostril in terms of where it is if thinking of a vertical line through the body.
Any idea what this could be? The surgeon didn’t really give much comment on it when I mentioned it as the follow up. He’s possibly willing to consider taking out my stylohyoid ligament and trim the thyroid lamina re my swallowing issues but wants me to wait 6 months. I’m not sure what this pain is coming from though. Anyone experiences something similar pain wise from eagles? It’s definitely only started since the surgery, yet it’s further back and higher up than the surgeon would have gone with the hyoid/thyroid horns surgery I had so i’m confused. It’s either something has shifted in there, or some muscle issues, or somehow the surgery has uncovered pain from stylohyoid ligaments, but then i’m not sure if the pain is stemming from the stylohyoid area.
@Callmestar1 - It sounds like pain that the trigeminal nerve can cause, & it makes sense if your styloids are elongated or stylohyoid ligaments are calcified. Because of your hyoid/thyroid surgery, things could have shifted a bit bringing your styloids into closer contact w/ the nerves in your neck. The trigeminal nerve is very often irritated by styloid &/or calcified s-h ligaments. I speculate it’s possible that having a styloidectomy/removal of the s-h ligaments could be helpful in resolving your current pain.
Not sure if I’ve understood exactly where your pain is @Callmestar1 , if it’s the back of the throat or roof of the mouth then it could perhaps be the Glossopharyngeal nerve, if it’s more throat then could still be GPN or the Vagus nerve otherwise? Both these nerves and the Trigeminal nerve that @Isaiah_40_31 suggests are all commonly affected by ES, & also during surgery in that area…do I remember right that you still have your styloids in? It could be that the recent surgery has shifted something as you said… it’s rough for you not being able to find the answers to your symptoms
