What is the recovery like for a transverse process shave (1 cm) and styloidectomy? I also have CCI that’s causing the jugular vein compression.
My symptoms been all over the board.
Have you got a date for your surgery @Luckee7 ?
There’s info for general styloidectomy surgery recovery in the Newbies Guide Section here in case you haven’t seen it:
ES Information- Treatment: Surgery - Welcome / Newbies Guide to Eagle Syndrome - Living with Eagle
I did a quick search for past discussions about Dr Nakaji’s surgery specifically, so here’s some you could read:
Day 1 post surgery with Dr. Nakaji - General - Living with Eagle
Heading to Phoenix - General - Living with Eagle
Surgery with Dr. Nakaji Post op report - General - Living with Eagle
2 Weeks Post Styloidectomy and IJV Decompression - General - Living with Eagle
Post Second Surgery Update - General - Living with Eagle
It can be quite a tough recovery, and because of the swelling the symptoms can take a little while to go, and it can take your brain a while to adjust to the change in vascular drainage/ pressure, so don’t be worried if you wake up from surgery & don’t notice any difference!
Hopefully some of the members who’ve had this surgery with Dr Nakaji will give you advice/ info…
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Hi @Luckee7 , I had a unilateral decompression with Dr Nakaji in Sep 2025. It consisted of transverse process shave, carotid sheath fasciectomy down to C4, and cutting my stylohyoid muscle, which was straddling my IJV. I did not technically have a styloidectomy, as it turned out I did not have a styloid on that side (what seemed to be the styloid on the CTV was instead just a calcified mass). My recovery was pretty good. By day 4-5 I was basically back to pre-op baseline in terms of activity, including doing cardio. I still had some pain, but it was mild enough not to interfere with my day-to-day life. It went away fully over the following week. I’m now 4 months post-op and the only thing left is a small patch of skin that is slightly numb above the incision. The scar is barely visible.
The most important piece of advice I received from Dr Nakaji was to move my head as much as I can post-op, even though it hurt. I chose a subjective level of pain I could bear (about a 7 or so), and I tried as often as I remembered to gently move my head in all directions, while staying below that pain threshold. The rate at which my pain subsided increased considerably once I started doing this.
For context, I don’t think I have CCI, and I’m in my mid-20s.
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I’m glad that your recovery wasn’t too bad @crumblecookie & thanks for the info! I’d not heard about that advice to move your head about gently, that’s interesting as another member mentioned Dr Aghayev suggests people keep upright and try to walk as soon as they can to help speed healing up…
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My understanding from what he said is that keeping your head mobile immediately post op is really important to avoid losing your range of motion as healing occurs. It’s important to respect the healing process, of course, not overdo things, and generally apply common sense. He explicitely prohibited weight lifting or anything that puts too much tension on the neck or involves straining, but encouraged being active. I do want to stress that this advice may not be generally applicable though, it may have been specific to my case, so people should always check with their surgeon of course.
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I’d say the recovery has been longer and more drawn out than I expected but not that significant.
What I mean by that is the initial surgery pain and such was very short like crumblcookie said, but I have nerve irritation, numbness in my face, irritation looking to the side for too long a few months later.
It’s workable, and I do ice/ibuprofen, and much better than the initial state when I had the styloid, but definitely worth noting. Id also expect it to go away in a few months or when the other one is gone, will let you all know.
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