Stylohyoid Ligament & Hyoid Bone Surgery | Bonn, Germany, 04/05/18 and 05/30/18

Hi everyone,

I’m having surgery next week in Bonn. Dr. Nils Heim is my surgeon. He will take out both the calcified stylohyoid ligament and the (probably) fractured styloid process on the right side. In this thread I’ve shared my experience so far:

I’ll share my progress post-OP in this topic. Here are my symptoms pre-OP when they are at their worst (0=no pain, 10= very painful):

Stinging foreign body sensation: 8/10 (on the right side)
Neck pain: 7/10 (both sides)
Occipital pain: 7/10 (on the right side, just below the skull)
Jaw pain: 7/10
Shoulder pain: 5/10 (right side predominantly)
Throat pain: 7/10
Eye pain: 4/10
Temple pain: 7/10
Tinnitus: 6/10
Ear pain: 1/10 (just a weird feeling in my right ear, but not painful at all)
Swallowing difficulty: 5/10 (especially saliva, food not so much)

Tingling situation in my arm is pretty much gone now, cervical spine surgery seems to pay off after all.

I got problems talking, coughing and yawning as my jaw is extremely locked and symptoms worsen if I move my jaw and/or neck a lot. Running makes things worse, too, as does staring at a computer for a long time and doing exercises such as push-ups and particularly sit-ups.

I’ll keep you posted! Any tips for a better recovery post-OP are greatly appreciated.

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Hi Michael,
No surprise you have trouble when you do things that strain your neck muscles i.e. sit-ups, push-ups, or involve holding your head in one position for a long time. Neck flexion during exercise aggravated my ES symptoms terribly & most likely because the flexed muscles put pressure on the ligaments which in turn likely stressed the styloids. Surgery should help that problem stop.

The top tips for speedier recovery are these:

  1. Follow your doctor’s pain med instructions closely (even setting an alarm to wak you up during the night) and take the pain meds for the prescribed length of time. You will not become addicted to them in the 2-3 weeks you may need them. I had to take mine for 2 weeks & off & on for a month. Some people don’t need them beyond the first week.

  2. Get several covered gel ice packs & put them in your freezer. You will want to start using these ASAP after surgery - 15 min on & at least 45 min. off. Do this 3-4x/ day or more often if needed to help reduce swelling & pain.

  3. Buy a wedge pillow & additional bed pillows if needed. - so you can sleep w/ your head elevated to at least 30º for the first week or 2 post op. I ended up sleeping that elevated for about 6 weeks as every time I tried lowering my head, my throat would start to swell. I believe Jules & some other people also found they needed head elevation longer than just the first week post op.

  4. Let your friends or family take care of you - doing food prep, getting you ice packs, getting your meds ready for you, etc., for the first 2-4 days post op

  5. Be aware that opioid pain meds are very constipating. If your doctor doesn’t prescribe a laxative & stool softener, make sure to buy them on your own. Magnesium citrate works well for that, too, & if you buy it in powdered form (as opposed to capsules), you can titrate it to the concentration that works best for you.

  6. BE PATIENT! Listen to your body. When it says rest, then rest. “Don’t jump in w/ both feet” the day you start feeling better. “Test the water” w/ your toe i.e. start back to your regular activities very slowly & gently. Getting too tired or stressed early in recovery WILL set your healing back & slow it down overall. Plan on a couple of weeks of really taking it easy - caveat - you are on the younger side, so you may recover faster & may not need that much time.

  7. Eat what you feel like eating. Cool liquid (smoothies, shakes), soups or soft foods will probably be most comfy for you in the first several days post op. A blender will be your best friend. Some people’s jaws get stiff so chewing is challenging for awhile. I had full meals blended for me - meat & veggies blended w/ almond milk or water. Looked awful but tasted great.

There you have the basics. Hope this info helps!

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I think that’s covered everything!
There are links in the Newbies Guide section to post-op recovery stories, or you can just search for them if you want more of an idea, but everyone’s experiences are a bit different depending on the method of surgery etc.
Hope that your surgery goes well, & best wishes for a speedy recovery!

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I’d suggest also that you should start taking short walks (maybe of ten to fifteen minutes’ duration or so, a couple times a day) as soon as you can post-surgery. A little bit of very moderate physical activity will help you recover faster, as long as you don’t overexert yourself.

Good luck!

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Thanks to all of you, great tips!
I‘ll let you know how it went ASAP on Thursday.

Thank you for this addition! Moving a bit & not being totally sedentery is very important - keeps the blood moving!


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Surgery went well. I do believe it helped already, but then again I‘m on painkillers.
Feeling quite optimistic anyway.
More updates soon, will talk to the docs tomorrow

That’s EXCELLENT news, Michael. Did you have bilateral surgery? Hoping to hear a great report next time you post. Praying for you to have a complete recovery devoid of pain/other symptoms.
:blush: :sunflower:

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Good news! Make sure you take it easy & keep up with the painkillers! :grinning:

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Feeling quite good today. I can breathe very calmly (quite an unusual feeling) and the pain gets better with every hour.
They‘ve only done my right side.
Doc spoke to me today, he said the styloid itself and even the little fragment were ok, just surrounded by tissue and not pressing on any vital structures. But the stylohyoid ligament was all over the place, virtually pulling my hyoid bone upwards and pressing it against blood vessels. Kind of like the ligament strangled my hyoid bone, according to the surgeon. Might be caused by my neck trauma, but you can’t know for sure.
So he left the styloid as it is and took out the calcified ligament, as well as shortened my enlongated hyoid bone a little. As far as I can tell, that was an excellent choice. The stinging globus sensation is very alleviated.

He said there are now three options:

  1. It won‘t help long-term if it wasn‘t the cause of all the issues (unlikely)
  2. It well help long-term
  3. It well help long-term on the right side, but the left side might get worse

If that happens, he will simply do the same surgery on the left side.

As of now, I‘m pretty happy with the outcome, looking forward to making a full recovery yet prepared for any setbacks. Feeling very optimistic, though.

Thanks to all of your support!

Will post another photo once the patch is gone. The scar doesn‘t hurt at all. I can chew very well, swallowing is a little difficult at times.

And that blue neck pillow works wonders by the way. :wink:

Sometimes the second side does get worse after surgery, don’t know why, but be prepared for that- something to look forward to, hopefully it won’t! I hope that you keep on improving!

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Wonderful news, Michael! So glad you’re feeling this good so soon after surgery. It sounds like you have a great surgeon. It was worth the time & research it took for you to end up w/ this great outcome. Hoping & praying it will be for the long-term!


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Update three days after surgery: It‘s pretty up and down. There are times where I don‘t have much pain swallowing and talking, then the neck, jaw and throat pain intensify pretty quickly. I take Ibuprofen three times a day but it doesn’t feel like it makes a huge impact.
The pain is different, though. It feels like it doesn‘t get much worse when turning my head and talking, which is a big relief.
I expected healing to take long but I‘d be happy if it was a steadier process instead of in sinus waves.

And of course, the usual neck/shoulder issues are far from gone, but then again it‘s impossible to relax when you‘ve got a burning sensation in your throat from the surgery. They‘ve taken out part of the hyoid bone, after all, so I reckon that‘s normal.

Anyway, as of now I don‘t regret the decision at all, it definitely didn‘t get worse and I‘m feeling quite optimistic.

Doc said we‘ll just see how things turn out now - if the pain subsides on the right side, he suggests going ahead with surgery on the left side too.

I‘m allowed to do sports after three weeks by the way.

This is how the scar looks like. Pretty neat if you ask me, quite happy with it.

Hi Michael!
Thank you for the update. Your incision looks fantastic! Not much local swelling. That’s great!
Days 3-5 post op are the days the internal swelling is the worst & will be the time you have the most post op pain. It gets better from there. By the end of the second week you should notice a significant reduction in your pain level. I’m surprised you’re ibuprofen as it’s a blood thinner & not usually used immediately post op. Most docs prescribe opioid pain meds for at least the first week or two. Glad you’ve planned on the full recovery taking awhile.
I started back to exercise about 2-3 weeks post op & it was too early. I participated in an organized 15K running event 6 weeks post op which was a big mistake. I jogged the first half & walked the second. I didn’t feel very good by the finish. As you’ve read over & over - the key to quicker recovery is LISTEN to your body & even when you have a day where you feel pretty good, approach it w/ baby steps not by leaps & bounds. For some reason this surgery just kind of sucks the energy out of a person but w/ time it fully returns.
Continue resting & you’ll be up & around soon.

Yes, if the last two years taught me anything it‘s patience. ^^
I didn‘t get prescribed any meds. I asked for Ibuprofen and my doc said that‘s fine. I‘ll take it for one or two more days and then see if I can cope without.

Feeling quite ok today. The usual wound pain and throat/jaw/neck tingling stuff, but better than yesterday. And I’m off pain meds, haven’t taken Ibuprofen since yesterday evening.
Off to Munich now. Will keep you posted. :slight_smile:

That’s fantastic news! May you heal well & quickly!

Day 6: Feeling knocked down today, massive neck pain and burning sensation in my throat on the right side.
Back on ibuprofen and will rest today. Chewing is still a little awkward. My right sternocleidomastoid is stiff as a poker. Feels like any sort of wrong jaw movement or sleeping position triggers the whole chain of pain immediately.

But I guess setbacks were expectable. I‘m positive nonetheless. :slight_smile:

Poor you- not unexpected that you’ll have a bad day or 2, maybe keep on the ibuprofen a couple more days. Take it easy!

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