Three Month Post-Op Update (Right Side)

Hi Everyone!

Just wanted to give an update. I had a right styloidectomy with Dr. Cognetti three months ago. I did have nerve numbness and first bite syndrome after surgery. (side note: I read a lot about first bite on this forum prior to surgery and wondered what it felt like but I knew immediately when I did!) First bite symptoms went away about a month after surgery. The nerve numbness in my jaw and chin has improved significantly and honestly don’t even notice it most of the time. Most pre-surgery symptoms have improved including the sensation of something stuck in my throat, ear pain, and my singing voice has improved (not 100% but a lot better than before).

The only issue I’m having is swallowing. The minute I woke up from surgery I felt a click in my throat (which wasn’t there before). It hasn’t really gone away and I now I feel like the left side (which still has an elongated styloid) is the side giving me trouble when swallowing but I’m not sure. It almost feels like the muscles on the right and left are going in different directions. I’m hoping once Dr. Cognetti removes the left side this will go away but I’m also unsure this “tug” is because of the surgery or because I still need the left side removed.

Anyone else have the same issue after their first surgery?

Really pleased to hear that most of your symptoms have gone with surgery…
@SewMomma had clicking before and after surgery; her stylo-hyoid ligament was calcified more from the hyoid up. I think her click did go eventually but it took a while…If one side has been ‘tethered’ by a calcified ligament & then released, but the other side is maybe still tethered it could be causing the tug/ click?
Here’s a link to SewMomma’s story:
Thankful for you all - General - Living with Eagle
So you’re definitely planning on having the second side removed? Have you got an idea when another surgery might be?


Great to hear from you! When you have one styloid & the s-h ligament removed on one side & the other is elongated & still in place, it is not uncommon to feel “unbalanced”. One side has been freed up while the other side is still tethered. It makes perfect sense that you would have symptoms relative to that scenario & a clicking sound or sensation is very typical of that scenario. I suspect that when you have your second styloidectomy, the clicking will be gone, the swallowing issues will resolve & you’ll feel soooo much better!! I had bilateral ES, & it took two surgeries for me to fully recovery from my symptoms.

I’m thrilled to hear your singing voice is recovering! We have many singers on our forum but not many come back to let us know whether or not surgery helped w/ singing voice recovery. I hope yours comes back !00%. I’m really glad for the recovery you’ve had. Sounds like you chose the right surgeon to do your ES surgery(ies)!!

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Thank you so much for responding @Jules and @Isaiah_40_31 ! And thank you so much for attaching @SewMomma story. That was definitely really helpful to read. I had a post op follow up with Dr. Cognetti today and he wants me to try swallow therapy for a couple of months to see if it helps. If it doesn’t, we will go for the second surgery, although I know in my heart I will feel much better with both sides removed. I am just going to trust the process and not rush. I’ll keep you guys posted on the swallow physical therapy. It’s only been 3 months since my first surgery. How long do people wait in between?



I am 2 months post op from my right side surgery. My surgeon did my right side due to it having the most jugular compression even though I never had pain on my right side. The pain and ear pressure have always been only on my left side. I have heard that having bilateral ES can cause the other side to flair up if one side is removed. I am praying that this is what is happening with me and that removing the left side will help the horrible pain and pressure to subside. I hope that others who have had bilateral ES can chime in on having the remaining side causing issues. I thought my left side was bad before…ouch.

I hope that our issue is just needing the remaining side taken out. Please keep us updated on how PT goes.

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@Eagle1 Thanks for chiming in. When are you looking to have the left side removed? I’ll definitely keep you guys posted as I go through PT. I’ve gotta say I never did feel my left styloid poking me because the right was physically sticking out through my tonsil and touching my tongue but now I can feel a “baby poke” on my left side. It’s funny how that works. Our bodies ignore the less problematic side.

I will be seeing Dr. Hepworth next week and am very anxious to hear what he plans to do. I have TMJ on my left side too, but I was told by the TMJ specialist that found my ES that my TMJ isn’t that bad and it is the ES that needs to be dealt with first. The left side pain was bad before but it is EXTREME right now. Hopeful that this is ES related and that I am still on the right track for finding relief.

It is so interesting that you can feel a bit of a poke on your left side. I hope PT helps you find relief until you can get the left side removed.

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@Eagle1 Sending lots of good thoughts/prayers your way that you are on the right track to finding answers and Dr. Hepworth will be able to help!

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@MVO & @Eagle1,

Some surgeons will do a second ES surgery 3 mos after the first one & others prefer to wait a bit longer. I saw Dr. Samji for my surgeries & at the time of my first one (2014) he required 6 mos between surgeries. Now he’s reduced that to three. It is my opinion that even though 6 mos seems like a long time, healing from the first surgery is much more complete by then & recovery from the second surgery isn’t as difficult (my experience). Mine ended up being 9 mos apart (not by choice but by “accident” i.e. a cycling accident w/ a head injury just prior to my second surgery date) which was a difficult wait.

Eagle1, I was exactly where you are. My left styloid was the problem from the beginning. It was why I was diagnosed w/ ES, yet because of the angle & thickness of my right styloid, it was removed first. My symptoms from the left side were nearly unbearable by the time I had it removed. I completely sympathize w/ your situation & hope that Dr. H is willing to move ahead w/ a seond surgery at some point in the not too distant future.

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Generally seems to be 3 months minimum, I ended up with a year between mine, mainly because of the UK waiting lists!