I don’t want to create 2 posts for my questions and added both the question in this post.
I have been dealing with constant lower jaw pain under the ear and neck for 11 months now. I have some lump spots in the neck and under ear which didn’t show up in the neck ultrasound and CT scan.
I don’t have any definite diagnosis yet. OMFS and ENT said it’s muscular and asked me.to do physical therapy.
I don’t have any diagnosis for eagles syndrome. I sent my reports and disc to Dr. Samji office. He dismissed my case as I am not meeting his criteria for his patient. I couldn’t find any other eagles provider yet for my diagnosis.
Meanwhile, I contacted my PCP to prescribe me something for my pain. She has put me in carbamazepine and Cymbalta before. I tried both for few weeks and didn’t help at all with my pain.
So, she put me in amitriptyline 25mg to try with. Pcp wanted me to try that for few days and see if it helps with my pain.
Anyone tried Amitriptyline and did it help with your pain? How long did you take to see relief?
I am on it for a week now and yet to see changes in my pain. It just makes me so drowsy and makes me sleep through the night which is a plus for me. I always wake up twice or thrice at night with pain. With amitriptyline , I just wake up early morning with pain. I wake up only with pain pushing me under the ear and the neck /throat. Kind of poking through something in the throat and wakes me up.
I am currently doing Physical therapy with trigger point dry needling. I started it last week and had one session of needle on the Scm so far. It gives electric shock or twitches on the ear and lower jaw area. PT wanted to dry needle all the surrounding muscles around my tmj. I have been told I have Myofascial pain dysfunction syndrome.
And coming to the second question,
Do anyone have segmented styloids? My cbct report of tmj shows my styloids as segmented. My CT neck scan report didn’t mention as segmented styloids. But the report shows values like segmented or into 2 parts.
I did ask Dr. Samji office about this and I got the response as, he doesn’t work on segmented styloids and doesn’t have anything to say about it.
I don’t know if my styloids are segmented and if I have eagles or not. Yet to get the definite diagnosis.
Adding the report here:
Right styloid process: Not elongated, measuring about 0.3 cm.
Right stylohyoid ligament: Calcified distal portion, which measures
about 0.8 cm. This is located about 2.1 cm from the tip of the right
Left styloid process/stylohyoid ligament: Borderline top normal size of
the left stylohyoid ligament, which is in continuation with the
elongated left styloid process, measuring about 2.4 cm combined. One
cannot differentiate between what is considered the left styloid process
and a calcified stylohyoid ligament in this case. In regards to Eagles
Syndrome, an elongated styloid process or a calcified stylohyoid
ligament can both result in pain. Eagles Syndrome is ultimately a
Two BB markers were place in the region of focal pain in the right face
and right neck. There is no focal abnormality underlying these BB
12/28/2020 3:43 PM PXRRR02R
Addendum: The left stylohyoid ligament is calcified and measures 2.4 cm,
which is borderline top normal. This is in continuation of the left
styloid process, which essentially can be considered elongated.
12/24/2020 4:26 PM RAADOCS006
Addendum: The right styloid process is not elongated. The calcified
distal portion of the right stylohyoid ligament measures 0.8 cm and is
located about 2.1 cm from the tip of the right styloid process.
12/24/2020 3:47 PM PXRRR14R
Additional clinical indication: Evaluation for Eagle’s syndrome.
The left stylohyoid ligament is calcified and measures 2.4 cm, which is
borderline top normal. The right stylohyoid ligament is mildly calcified
along the distal aspect on series 4, images 34-35.
CT SOFT TISSUE NECK W CONTRAST
TECHNIQUE: CT images of the neck were obtained with intravenous
contrast. Isovue-370 was injected without complications. Dose reduction
techniques were utilized for this examination. DICOM format image data
is available to non-affiliated external healthcare facilities or
entities on a secure, media-free, reciprocally searchable basis with
patient authorization for at least a 12-month period after the study.
CLINICAL INDICATION: Lymphadenopathy, neck;Localized enlarged lymph
COMPARISON: Neck ultrasound August 28, 2020.
Aerodigestive Structures: The nasal cavity, nasopharynx, oral cavity,
oropharynx, hypopharynx, larynx, and included trachea and esophagus
demonstrate no masses or abnormal enhancement.
Lymph Nodes: No pathologically enlarged, necrotic, or otherwise abnormal
Salivary Glands: Normal parotid and submandibular glands.
Visualized Intracranial Structures: Normal.
Included Orbits: Normal.
Paranasal Sinuses/Mastoids: Predominantly clear.
Included Lung Apices: Normal.
Bones/Soft Tissues: No aggressive osseous lesion. No acute soft tissue
Any thoughts anyone. Really appreciate it.