So what's the problem with the internal surgery?

Hi all,

I met with the surgeon yesterday. I was a bit concerned about his level of experience, but we talked for while and I am not worried about that anymore. I think he was happy to have someone knowledgable to talk to!

He has done the internal surgery several times, and the external surgery once. He recommends the internal method because it is quicker, less invasive, and he says the results are the same without the same level of risk.

I know that several of you have mentioned that the internal procedure does not remove as much of the styloid, so I asked him about that. He says that, using a curette, he removes the styloid all the way back to the skull. Is there something I am missing here?



I always thought that the main problem with intraoral surgery is that they can't visualize everything as well and they can't get as much of the styloid out. But hey, if he can take it all out with intaoral, then that may sound good. That's the first I've ever heard of that, so he may have something new.

I have heard that there's a greater risk of infection with internal surgery, but I'm sure the doctor can keep on top of that. Best of luck to you. Please keep us posted.

Thanks for your reply. I will definitely quiz him a bit further, but if he lives up to his promise, I'll be happy!

Hi eAmator;

I've had both--3 external and one internal. You can get enough using both. The doctor is the factor and needs to be knowledgeable enough (or told) to know to get as much as he can--not just a shortening or a trim. I was told that external had less chance of infection and a better angle but in my case the last 2 externals were crap jobs--they either took out wrong part or just took 3 cm of 7.5 cm styloid.

Last year was my first and last internal because the dr. was able to cut it back up to the base of my skull removing 3 more cm. Its even a little shorter than the right one that was done externally in 1990. The pain is a lot more and healing took longer-but it worked.

Here is a u-tube like showing what I think he did.

There are others on u-tube to checkout.

If you have dr. who has done this before and is willing to and going to do it and you feel confident in their approach--go for it. After 15 years of pain my recovery was nothing much--and now I'm ES symptom free.

the symptoms of the mistaken removal of my hyoid bone in 2002 were masked by the pain of ES but they are minimal compared. Just make sure they and all present know what you are supposed to have removed. No one deserves to hear oops!

Take care and I hope it all goes well.

Hi Shaw,

Thanks for this. I talked to the surgeon about his technique, and that youtube video is exactly what he described.

I suppose that unfortunate (or downright malpractical) errors like your doctor's are more likely to happen with an inexperienced surgeon doing the external approach. There is a lot to look at in there once the neck is opened up... but the internal approach follows the styloid from tip to skull.

yeah he messed up but he did so well in 1990! I thought he would do the same in 2002--surprise. yes I call it malpracticy. the problem was I was not bilateral. Symptoms on right side started in 1989, on the left in 1996. So I'm not sure where he lost his skill along the way-but he blew it big time. Last year I made sure everybody in operating room knew why I was there. They ask you why you are here along the surgical process--I asked them back due to what happened before. just scream "styloid removal" in the halls!