All - an update to my original post. I had a CT scan without contrast and unfortunately, they did not find any elongation or calcification of the styloids. I was shocked because my symptoms lined up with eagle to a T, and I can literally feel (what I thought were) the styloids on the side of my neck away from the jaw line. My question is - could I still have some sort of compression/weirdly Angeled styloid which could be causing issues? Just holding out any hope that this could still be eagle because the alternative seems like it would be CCI (based on convos with chat GPT).
Symptoms include
• Voice tightness / strain
• Loss of vocal resonance / nasal buzz
• Globus sensation (lump or pressure in throat)
• Clicking when swallowing
• Choking sensation when lying flat or tucking chin
• Weak or absent gag reflex
• Loss of upper throat sensation during swallowing
• Constant throat clearing / mucus buildup
• Ear pressure and popping when swallowing
• Crackling or snapping sensation when pressing under jaw (like fingernail clipper)
• Tender, hard structure under jaw (cracky on touch)
• Swallow-induced clicking
• Symptoms worsen with THC (vagus sensitivity trigger)
• Palpable pressure or pain along styloid path
• Worse after talking, swallowing, or upright activity
• Brain fog flares when upright or post-exertion
• Temporary relief when reclining
Hi there @AugustWest94 . I’m sorry that you didn’t get clear answers based on your most recent CT scan. I am sure that you are frustrated because you are having a lot of symptoms and no one can seem to figure out what exactly is going on. I had CT scans, x rays, & MRIs & finally an ENT said that it could possibly be something called “Eagle Syndrome” but not to worry about it if my symptoms weren’t interfering with my life. After looking into it more myself & joining this forum which provided so much information, I went to one of the doctors recommended here to have him look at my images to see if he saw anything concerning. At that consultation, he said that he would go ahead right that day and schedule me for bilateral surgery for Eagle syndrome. So I was then officially diagnosed with that. I had been seeing multiple doctors who looked at imaging and they never picked up on the styloid involvement. I did do a little more investigating because I wanted to avoid surgery if possible and see if there was anything else I could do. I went to ,FL to have further imaging and an atlas-orthogonal adjustment to see if it would help at all (it didn’t) and the doctor there also recommended that I have surgery. I say all of this to encourage you to not give up trying to find the answers because you have a lot of symptoms that can be consistent with ES. I also just watched a video on CCI and some of your symptoms sound similar to that as well. If you haven’t already done so, I would suggest going for a consultation with one of the doctors recommended on this forum who have treated ES and know exactly what to look for and who can give you an expert recommendation of what else you can look into if it is not ES. Some of your symptoms also seem like they could be involving the hyoid bone. It is pretty complicated because the symptoms can vary so much from person to person and there are so many structures in that area of our bodies. I hope that you will find the answers very soon.. BTW, I am in VA too. I didn’t find any doctors in my area that seemed to have any expertise regarding ES. If you know of anyone, please let me know. Although I had bilateral compression, I have only had the operation for one side, so may have to have another surgery in the future.
I agree w/ everything @vap told you. We have quite a number of members who’ve been told they don’t have ES when they’re styloids were very long or ligaments were significantly calcified. It’s crazy that a radiologist/doctor would somehow look at a gnarly set of styloids & say nothing is wrong, but it happens.
I am highly suspicious that your hyoid bone is involved in your symptoms. You can contact Dr. Karuna Dewan in Louisiana to see about getting a consult w/ her as she specializes in Hyoid Bone Syndrome & would certainly be honest with you about whether or not your hyoid is a problem.
Dr. Hackman in NC is very experienced w/ ES & would be a good choice for a second opinion which I think you should get.
•Dr. Karuna Dewan, Ochsner LSU Health Shreveport - Academic Medical Center - Specializes in Hyoid Bone Syndrome surgeries
1541 Kings Hwy, Shreveport, Louisiana, 1-318-626-0050
•Dr. Trevor Hackman, UNC Ear, Nose and Throat Oncology Clinic – in the N.C. Cancer Hospital, 101 Manning Drive, Chapel Hill, NC 27514, (984) 974-6484
I agree with the others, we’ve had so many members who have had CTs done & been dismissed with nothing untoward, then we look at copies of the imaging & they do have elongated styloids! Sadly there’s a lack of understanding about ES still, plus it’s not just the length of the styloids which can cause symptoms, but the thickness and angle too, as well as the space between the styloids & C1 processes…As @Isaiah_40_31 mentioned about your hyoid, that may not even have been evaluated either. I certainly wouldn’t give up, try & get copies of your imaging, and as the others have said see if you can get a consult with a doctor who has experience.
Keep strong!
Your styloids may not be overly long, but they look pretty snug to your C1, and area where the internal jugular vein passes through.
Do you have the non-3D of your imaging? I find the axial view the best to see the compression. I’ve attached what the axial view looks like with my own imaging. Even without contrast the axial view can give you a good idea about the styloid-C1 distance.
Not with me but can grab that view and send it after work and tag you! Would there possibly be vagus/glossophareangal nerves there? The reason I ask my main symptom is vocal/throat issues which idk if the jugular involved that @TML
Yess! Between the styloid and C1 runs the IJV and both those nerves. See attached a photo showing where they are. If a styloid is too close to C1 than it could pinch all of those. Another area potentially worth checking in the axial view is your hyoid bone to see if they are jabbing into the carotid arteries, because the nerve run around down there too! Here’s a screenshot of the left greater horn of my hyoid bone jabbing into my carotid sinus, an area where vagus and glossopharyngeal nerve is as well.
Here’s the diagram showing the nerves around the carotid arteries which are typically at least nearby the hyoid. Sometimes (like me) the hyoid will get hung up in the area and wreak chaos
