I was diag with Eagle syndrome in Nov 2014. I was experiencing pain when swallowing on the left side of my throat for over 6 months. After many visits to different ENT's with no clear results I found one that suspected Eagle Syndrome and he suggested that I get a CT scan with contrast. The scan stated that both my styloid process was elongated with my left side longer than my right. At first he recommended that I take meds and see if the inflammation will subside on its own which it did after 2 months but then came back hurting even more. He finally said the next step is surgery through the mouth for both sides. It was a difficult decision to make considering the risk and damage it can do but I chose NOT to live with pain for the rest of my life. On June 20 of 2015 I went for surgery and right before I went into the procedure room I told my ENT surgeon that after reading MANY posts on this forum I want him to be extremely careful when he cut his way to my styloid due to all the nerve tissues that surround the area. I DO NOT want to have my face paralyzed and or drool for the rest of my life... Because of what I said before the procedure he decided to fracture the calcified styloid on both side instead of taking them out. He said that in order to take out the elongated styloid he would risk doing much damage around the area and said that fracturing is sufficient which will eliminate my throat pain. I was skeptical at first thinking that it might just mold back together or grow again the future but so far I am almost 4 months after the surgery and I do not feel any pain or have any symptoms. Don't get me wrong the first 2-3 weeks was hell after the procedure but after I am so glad I went with my gut but maybe its still too early to tell. I'll follow up here in 6 months with my progress.
I'm still skeptical about the fracturing vs taking it out but my surgeon assured me that its fine. He said he took time to break the calcified bone in many pieces so most likely it will dissolved into the tissue. I try to press on my neck looking for the fractured bone but I can't find or feeling any of it. Anyhow I guess only time will tell.
I've never heard of this method before. Interesting. Is there any chance that the pieces will come in contact with nerves and possibly cause pain and/or damage? There are so many nerves in that small area. It seems to me that as long as the doctor is in there doing the surgery, it might be cleaner to just take it out completely.
This is a bit of a dilemma for me to know what to add to this post- I don't want to worry you EagleFree, now that your op is done, but equally feel that a word of caution is needed for other members. There are a few possible theories as to the cause of ES, but several doctors I've read about have suggested that fracture of the styloid process (from a car accident, trauma, epileptic fit, even yawning or laughing could cause it!) can result in proliferation of granulation tissue, causing stimulation to surrounding nerves, for example glossopharyngeal, trigeminal or chorda tympani nerves. Steinman called it 'reactive hyperplasia'- metaplastic changes in the stylohyoid ligament leading to ossification.
It sounds as though your surgeon has broken it into very small pieces, so hopefully these will be absorbed without any inflammation, but I have heard of surgeons breaking the styloid process into less pieces, so (in my unqualified opinion though) I personally would want the styloid process removed as much as possible. Yes, there are risks to nerves, but then leaving the styloid process in to compress or inflame nerves can do that too. It's something we all have to weigh up for ourselves though, so equally I wouldn't want to encourage anyone to have surgery if they didn't feel it was right for them. Best wishes to you EagleFree!
Let me clarify, my surgeon had all the intention to remove both calcified styloid before the procedure. This was made very clear to me, my insurance and the surgeon himself.
My left side was 3.9mm and 3.4 on the right. That would probably be considered shorter than most people diag with ES on this forum. The decision to fracture the styloid was only made after he cut his way in and realizing that to take both styloid out he would need to cut further. Assuming that not all human bodies are made the same and that my styloid was shorter or harder to get grip on he has to make a decision when he got in there. I’m sure he didn’t expect my styloid to be so hard to get to and given the situation he felt that fracturing would be the best course vs the risk of cutting further in. Let’s be honest, no surgeon in the world can claim they are expert with performing procedures on ES. There is just not enough study or people that have this rare disease for a mature crowd of surgeons that has a better idea of what to expect.
I’m sure he did consider if any of the fragments left can pose danger or pain later on but he told me it should dissolve into the tissue and blood. In another 6 months I’ll be happy to keep everyone posted.
I guess surgeons have to be flexible as they never know exactly what they're going to find, so things don't always go to plan. Hopefully your update in 6 months will still be that you're pain free!