I finally had my appointment with Dr. Krempl here in OKC, and I although it went sort of ok, I am not exactly thrilled about it. First, he was very skeptical and wanted to know where the diagnosis of eagle syndrome came from (probably because I was the one who found the problem and pointed it out to my ENT). He did come around once he saw the length of my styloids. however…
I don’t think he knows much about jugular compression and is really only familiar with the classic and carotid variant. He actually doesn’t think compression of the jugular is a problem, as (in his words) they actually can remove a jugular with little to no problem and do it all the time. I am assuming, however, this is only the case when the other jugular is open (I have bilateral compression).
He was skeptical of this causing most of my symptoms…there must be something about me that makes doctors think I’m crazy and it’s all in my head. Given the length of my styloids, he was willing to do the surgery (with a CT angiography first). (They are 35 and 36 mm), BUT would not take it down to the skull base. In his words, he wasn’t worried about leaving a half inch or so left since a normal styloid is 1/2" - 1". This made all of my alarm bells go off - given everything I’ve read and what you guys have stated. I DO NOT want to have to do this more than once…
Anyway, I am getting setup for a CT angiography and am waiting on Dr. Hepworth’s office to get back with me to schedule an appointment there. I hate to have to wait on the surgery, as I know he has long wait times, but I know it is the right thing to do as I don’t really think this guy knows much about my particular variant. Thank you guys so much for your guidance and help!
The one cool thing is I was able to get some 3D reconstructions of my CT scans,. I have attached a couple of pictures, unfortunately they are not contrast so you cannot see the blood vessels, only the bones.
the interesting thing about this particular scan (taken in August) was that I was wearing a cervical collar after being involved in an accident. The collar pulled up on my head enough that the space between the styloid and C1 actually opened up to a normal distance!
This is an image of a head CT that I had in February of this year, unfortunately it does not go down very far but on the very edge you can see that the left styloid is only about 2 mm away from C1. The right styloid (not pictured) is about 3 mm from C1. This is the normal position. With the cervical collar, the gap opens up to about 7 mm.