Hi everyone. I’m new to the group. Thanks very much for allowing me to join! I’ll try to keep this as short as possible.
I live in Canada and have been living with some symptoms for a while. I had seizures when I was a baby and since then have had a head tilt. It has never been addressed by any doctor’s ive seen but has been commented on, especially from my eye surgeon when doing my eye exams. I assumed neck pain was related to this. However, I have been struggling with headaches and ear pain/tinnitus for a long time. I saw an ENT who kind of brushed me off. More recently, I have had alot of discomfort/pressure in my sinuses and behind my eyes, pain in the right side of my jaw, neck, and ear (which i thought maybe was caused by tooth pain but my dentist said no). A handful of times I have experienced pain that has caused me to panic. When I let out a big yawn, I would get a very sharp, extremely intense pain in the back of my throat/tongue that would radiate into my right ear. It doesn’t last long but the pain has been so severe and felt like my throat was becoming paralyzed. I have had recent throat/neck pain and have noted some voice changes over the last year as well.
A referral has been sent by my dentist for a CBCT as she didnt see anything tooth or tmj related that would explain the pain. Ive attached a copy of my most recent panoramic xray in hopes any of you may have advise. I realize it may be hard to see, especially on a mobile device but hopefully you are able to zoom in. Thanks very much for any help or advise.
Hi & welcome!
I’m not great with tech so I’m not able to label the image for you, but looking at it up close, it does look like there’s some calcification both sides ; on the left side of the image (your right), you can see some calcification between the 2 markers, and on the right side of the image it’s just to the left of the clip.
Ideally, if you were able to get a referral for a CT with contrast , as headaches can sometimes be a symptom that blood vessels are being compressed as well- there’s info in the Newbies Guide Section I sent you a link to about what might be causing your symptoms. I think it’s worth your looking into this as a diagnosis, but appreciate getting diagnosed in Canada is difficult!
Can visually see calcified stylohyoid ligament on both sides. On your left side your styloid is normal length, followed by a small section of normal stylohyoid ligament, but then followed by calcified stylohyoid ligament. On your right side, it appears to be one continuous chunk of calcification. Nonetheless, they pass C1, an area where the IJVs pass by, so it’s possible your IJVs are being compressed. A head and neck CT with contrast would be an important next step. It will allow the radiologist to measure the calcifications and assess for IJV compression. Unfortunately, unless there is contrast involved, a CBCT won’t show vascular compression.
thank you so much. this is helpful and gives me some ideas of what to research online lol are you able to tell me what the area I circled in blue is? It almost looks like it follows or connects to the area you circled but there is a gap in between. Is this a bone? thanks again for your insight
The blue circled area is the hyoid bone process, which does look possibly a bit longer than average, when you get a CT does, as long as it covers the skull base to the hyoid bone then it’ll be easier to tell if it’s potentially an issue…
What you’ve circled in blue is either the hyoid greater horn, or more calcified stylohyoid ligament extending off the lesser horn of the hyoid. CBCT will help figure that out. Just unfortunate that the CBCT won’t further our understanding of any vascular compression that may be occurring
Unfortunately, being in Canada, its extremely difficult to get any medical help at all right now. My doctor is over run with patients and continually declines my requests for appointments. And when I do get an appointment she treats me like im inconveniencing her and doesn’t listen to my concerns. Ive learned the hard way i really need to push for help if i think i need it but its not easy. My dentist can refer me to an oral surgeon for a CBCT but as far as getting a CT with contrast… I feel like that will be impossible.
I totally get you there. I’m in Nova Scotia, arguably one of the worst areas in Canada when it comes to accessible and timely healthcare.
I wonder if you could get a CT with contrast through Maple? I got a neck MRI through there. If you argue that you are having intracranial hypertension symptoms and neck pain, I would imagine they wouldn’t hesitate to order a head and neck CT with contrast. Maple is very straightforward - it’s a virtual or phone consult that can usually happen the same day or the following day.
I guess i’ll find out once I get the CBCT!