I am interested to know what testing is beneficial prior to surgery in order to try eliminating additional surgeries? Are there recomendations or is this a case by case situation? So many variables! I was diagnosed by a CT with contrast and have seen 2 doctors who say I’m a candidate for surgery (4 - 4.5 cm), but neither have mentioned any additional testing. My symptoms are quite varied, as well as their frequency. How can you navigate through this diagnosis and find the right doctor and treatment? One doctor I saw said he would only do external surgery and the other said intra-oral as the styloids are close to where my tonsils were. I’m in the early stages of this journey and sure appreciate your comments!
The only time you need additional testing is if you have symptoms that might indicate vascular compression of either the internal carotid artery or internal jugular vein. I was diagnosed only by a CT w/o contrast prior to having my ES surgeries. That was all that was needed & both of my surgeries turned out to be very successful.
Here’s a post @Jules wrote that give information about vascular symptoms. In the absence of these, the scan you’ve had is enough for a doctor to diagnose you & offer surgery.
Thank you, Isaiah. Trying to wrap my mind around all this! I normally don’t have trouble understanding or remembering, but since this began I am feeling confused and struggling. Is it common to have these symptoms in addition to my other symptoms?
Mental confusion/brain fog can be a symptom of vascular compression. To get that figured out, you can have your CT w/ contrast re-read by the radiologist & have him/her look for ICA & IJV compression. Sometimes it doesn’t show up when the head is in neutral position which is the way CT scans are typically done. If nothing shows in your case, you can request an MRV & a dynamic CTA (head in different positions during the scan) along w/ a dynamic ultrasound of your IJVs looking for occlusion & different rates of blood flow above & below the point of compression.
Thank you so much for this additional information. It has really helped to guide me to the next step! This forum is truly a blessing!
There’s info about surgery in the Newbies Guide Section, and some suggested questions to ask doctors, here’s a link:
ES Information- Treatment: Surgery - Welcome / Newbies Guide to Eagle Syndrome - Living with Eagle
We generally suggest if possible that embers try to have external surgery; there are less risks as it gives better visibility for the surgeon, and also more of the styloid can be removed, which gives a better chance of resolving symptoms. So if one surgeon is offering external surgery and you feel confident with them, then they might be the better bet.
As you’ve had a CT with contrast already that’s good, I had bilateral IJV compression and just had the CT with contrast before surgery.
Thank you Jules! I appreciate all you do to help others! This is quite a journey and recently started it ! I know it will all come together with the help of this group.