Tongue weakness and TMJ problems after internal shortening of the styloid

Hi everyone,

I wonder if anyone else has had these problems occur after surgery (and after the initial healing phase). I'm currently about 2 months post op for shortening of the styloid on my right side. After the surgery my right TMJ was very tender and making a lot of noise. That healed after a few weeks and I guess it was mostly related to clamping my head in position during surgery. Then about a week ago it came back out of the blue. Crunching and clicking in ym right TMJ. I never had any TMJ problems before surgery.

The other problem I have is weakness at the front of the tongue on the right side. This causes my tongue to deviate to the right side both at rest and when it is protruded. This is very uncomfortable because it pushes up against my teeth on the right side even when I am just relaxing. I can feel it when I talk - it feels lazy. I had some tongue weakness prior to surgery and was never offered an explanation for it but it is quite a bit worse now. I assumed it was part of the Eagle's, however I believe the hypoglossal nerve that is mainly responsible for the tongue it not that close the the styloid process.

The styloglossus muscle and the stylomandibular ligament were removed along with the stylohyoid ligament during the procedure. I believe that this is normal during styloidectomy as these structures are attached to the end of the process - so I assume that most people out there who have had surgery have also had these attachements removed. I believe that the stylomandibular ligament is considered only an accessory to the TMJ to prevent opening the mouth too wide, although there is also some though that it plays a bigger role than this. Also the styloglossus is mostly responsible for movement at the back of the tongue from what I understand. So I don't see how this would explain my symptoms.

Has anyone else had similar experience after surgery? DID IT GET BETTER WITH TIME?

I'm really hoping it will.



Hi Mark,

I haven’t had surgery yet, but did want to mention something you should keep in mind for the future if this deviation continues…

As a medical first responder, one of the first things we look at to be sure a patient isn’t stroking, is their tongue. A tongue that won’t stick out straight is an emergency symptom if we don’t know your history. If it continues, wearing a medical wristband might be a good idea in case of an emergency so those treating you will stick to the right track.

Hope that helps :slight_smile:

Ellen Schnakenberg

I'm really glad you posted this Mark. I have a second opinion appt. this Friday w/ Dr. Samji (one of the recommended docs on Emma's list) & will ask questions about the problems you're having & specifically about the removal of the stylomandibular ligament & styloglossus muscle as part of the surgery & potential side effects from that. It seems like the more I read, the more complicated the problems caused by ES & surgery become. YIKES!!

Isaiah 40:31


I may not have understood some points of discussion. But in my case, with both styloids removed a few weeks ago (they were almost 7 cm) the surgeon did not remove muscles and ligaments. He pulled some muscles laterally to access the styloids and removes them. This surgery cuts some nerves of the neck. Nerves take longer to regenerate. I'm getting some positive results taking daily vitamin B complex produced by Merck.

I'm so sorry to read about your discomfort. I do hope you feel better soon. Did the doctor ever mentioned anything regarding the weakness or possible TMJ? For what I read from other patients, they don't have that weakness of their tongue or TMJ discomfort. What I've seen and read most of them have some numbness for a while, then after several weeks it all comes back to normal.

I hope this helps.

I don't think the tongue weakness is usual after this surgery. The ENTs that I have seen are stumped by it. When I protrude my tongue and move it to the side I get a grating noise in the area in front of the TMJ near my cheek bone.

I’m finally having surgery, November 14, Im pretty sure he plans to take the calcified Ligament. I’m having problems biting & chewing, as I can’t open my mouth very large. Also chewing & Swallowing, chewing just makes all the muscles you use hurt! Swallowing is due to the back of my tongue I can get the food down there but then I can’t get the back of my tongue to push the food to the back of my throat. So I need to flush it down real quick with water! I was concerned there could be more involvement with the GPNerve. Scares me a bit now but I definately must search the literature. Need to make sure doing the right thing!
Right now I really don’t have TMJ problems? I just can’t open my mouth very wide?i still have Daily Stress Induced Migraines! My Styloid’s are Bilateral and they meet at my Hyoid Bone. I am truly miserable. My biggest hope is Iight get some relief?