I was diagnosed with ES STING over a month ago by a neurosurgeon in NY. I live in Utah and have an appointment with Dr Pramrod Sharma on Monday, & another doctor the following Monday. I’m wondering what questions to be sure to ask at my appointments and how to know if I should seek more opinions after my appts. Really hoping to be offered treatment, I’m miserable.
Is there already a post about this somewhere? I couldn’t find anything with a search.
Hi Lacy,
The Newbies Guide & General Discussion sections have a number of posts about questions to ask your doctor. You can search the forum using the magnifying glass icon above. Use “Questions to ask” as your search phrase
Here is a basic list:
How many ES surgeries has he done?
Intraoral or external surgery?
Outpatient or inpatient?
How much styloid is removed?
Is the stylohyoid ligament also removed?
Do not walk in w/ a huge list of symptoms & give them all to the doctor. Keep it to basic, obvious ES symptoms like sore throat, ear pain, neck pain, something poking in your throat, clicking when swallowing, dizzyness…these are common symptoms of ES. You may not have all of them, & you likely have some I haven’t mentioned. More obscure symptoms will be dismissed as being caused by something else, but you will likely see them resolve once you have your styloids/stylohyoid ligaments removed.
The majority of ES symptoms are caused by irritated cranial nerves. These nerves exit your skull in the area near the styloids. Some go into the face & others through the neck where elongated styloids &/or calcified s-h ligaments can cause them to become irritated. The symptoms they cause can be quite varied & far reaching in your body. Doctors do not associate the varied symptoms caused by ES w/ the cranial nerves & thus often have no explanation for them. Vascular compression by the styloids or ligaments can also cause significant symptoms & that can be diagnosed by a CT scan w/ contrast. Some doctors prefer CTs w/o contrast. I’m sure Dr. Parma will let you know what he wants if you haven’t had one.
Please let us know how your appointment goes on Monday.
There’s a list of doctors in the Doctors Info Section if you don’t feel you get all the answers you want or don’t feel confident, you could see someone else from that list if you’re able to travel.
I think Isaiah has pretty much covered everything; I would ask about the risks of surgery (there are risks of nerve damage during surgery, & potentially a stroke, although this is rare, a good doctor should go through these with you honestly). You could ask about success rates for his previous surgeries- doctors don’t generally promise all your symproms will go to protect themselves, but if their surgeries haven’t helped a reasonable amount of patients then perhaps their surgical technique isn’t great! You could also check if they don’t remove the styloid processes to skull base, whether they smooth the tip off- we have heard of doctors who think snapping it off is fine& even leaving the piece in to float about & cause havoc!
You could also ask about swelling, & how that’s treated- some doctors use a drain, & some prescribe steroids; it can be managed otherwise with ice packs & keeping upright yourself…it wouldn’t put me off surgery with a doctor if they didn’t do any treatment, but helps to get a feel for a doctor’s attitude!
Let us know how you get on!
Hi Lacy,
I must be honest, I know what ES is but what does STING stand for? That’s a new one for me.
Styloid Induced Neuropothy of the Glossopharengeal nerve
Got it! Not an uncommon problem w/ ES. I had that & so have many others. Didn’t know it had such a fancy name though. 
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Most Drs don’t call it that. The neurosurgeon who dx’d me did but the surgeon I saw this week had never heard of it referred to by that name. It’s a fun acronym though
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Agreed, Lacy, I like it - ES STING!
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