Update: 5th day post op external styloidectomy

General
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Hi Everyone,

I just want to chronicle my experience since my left styloidectomy surgery on Tuesday morning 7-22-14. The first few days were rough. Lots of pain and dizziness. But this morning, I awoke with less pain, and so far, the dizziness/vertigo feeling has not hit me. Yesterday, the dizziness was so bad I had to lie very still with head down. I found that a small dose of Ativan (0.5 mg) helped the dizziness and nausea.

I had my JP drain removed on Friday (3rd post op day). It was in a separate stab wound next to the incision at base of my posterior neck. Pulling it stirred up a lot of pain for the rest of the day, but the next day I felt some relief with the tube out, and I am much more comfortable lying on a pillow now.

I appreciate the responses from those of you who reassured me that the post op pain I have been having is "normal" and hearing your experiences has helped me set more realistic expectations for recovery.

I am still very sore and tight (edema) so it's tough to fully rotate and flex my neck but it does seem that the scraping sharp pain is better already. I can flex my neck forward and backward without the sensation of a bone stabbing and scraping. I still have the sensation of fullness in my ear but it does seem to be improving a bit. I still have the sensation of something jarring deep in my ear when I walk and having the same muscle spasms deep in my ear. I am hopeful that as the nerves recover that will improve too.

One other thing to mention, my surgeon told me there was a risk of temporary or permanent nerve damage prior to surgery. I do have numbness in my left ear from mid ear lobe, along my left cheek and under my chin. I also have some nerve palsy (partial paralysis) in my left side of my lip. It is difficult to talk and eat. My surgeon has reassured me that the nerve was not permanently damaged but only traumatized from dissecting it and pulling it out of the way. Even though he prepared me for the nerve damage, it was still frightening and I was concerned that I would be permanently paralyzed. Here is what he said about recovery of the nerves: Motor function (lip paralysis) improves faster than sensory function (numbness) . Lip should be better in 2-3 weeks, numbness may take 2-4 months. I realize now that recovery from surgery will be much longer than I thought, knowing now that the change will be gradual has helped me have more realistic expectations.

Regarding pain, there is one sensation that worried me and I share this to reassure others. My throat larynx and pharynx and upper chest muscles became very tight from swelling after surgery. I felt pressure and a sensation of not being able to breathe. My doctor reassured me that my airway was not compromised and the Ativan did help me and the muscles relax. In terms of medications, Gabapentin has helped the nerve pain the most, I'm taking 600 mg (long acting "Horizant") twice a day, and a small dose of Baclofen (antispasmotic/muscle relaxer, 5 mg) twice a day for the ear and jaw muscle spasms as needed. I was on these meds prior to surgery. Since surgery, I'm taking Hydrocodone 5 mg 2-3 times a day. The low dose of Ativan helps the neck muscles relax so I can sleep. I expect to wean off the hydrocodone in a few days.

I appreciate all the information and honest answers many of you have shared with me, and I hope my information will be of help to someone out there too.

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What a hard road you are traveling. My thoughts are with you. I hope that this will relieve your pain long term. It is a lot to endure.

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sounds like your surgery has been a bit tough so far. Praying that you will heal fast and everything will work properly! Its so crazy how everyone on this site has reported different symptoms. I had my surgery June 13th 2014 and my symptoms are quite different. I had internal 4 centimeters remove from my left side. I have partial paralysis about the size of a golf ball in my left cheek. My neck is still tender where the incision was and I still have swelling. I have Slight tingling in my tongue and my gums are tender on the left side as well. one thing that I wasn’t prepared for was that I wouldn’t really be able to open my mouth. I can now open my mouth 1 inch but if I eat something that requires a lot of chewing It can be very tiring to my jaw and cause it to be sore, but I notice improvement everyday :slight_smile: take care of you!

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Scrappy, thank you for the words of encouragement!

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Thank your for sharing. I appreciate hearing of your experience, and your feelings and concerns. While my symptoms are minimal right now (I think...swallowing is getting a bit more difficult these days), I may be facing surgery in the next year or two...???

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Hi Mare,

I just had external surgery on July 17, 2014 in San Diego, CA. It's about 3 weeks post-op now. I was on oxycodone for about 10 days, and I also asked for a muscle relaxer and a non-steroid anti-inflammatory. Those both helped, but I am still in terrible pain when I'm not taking anything. The worst is that there is this big lump around the incision. Did you experience that? Also, did you find out how much of the styloid was removed? My surgeon said he only removed 2 cm. That doesn't sound like enough. Selaness80 had 4 cm removed from the internal approach. I thought the external was supposed to remove more. By the way, this was the first time he ever performed an internal surgery. He's done 2 or 3 internal. Also, do you still have the stabbing pain in the back of your throat? I do. I'm hoping they are just phantom pains.

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So Cal Char said:

Hi Mare,

I just had external surgery on July 17, 2014 in San Diego, CA. It's about 3 weeks post-op now. I was on oxycodone for about 10 days, and I also asked for a muscle relaxer and a non-steroid anti-inflammatory. Those both helped, but I am still in terrible pain when I'm not taking anything. The worst is that there is this big lump around the incision. Did you experience that? Also, did you find out how much of the styloid was removed? My surgeon said he only removed 2 cm. That doesn't sound like enough. Selaness80 had 4 cm removed from the internal approach. I thought the external was supposed to remove more. By the way, this was the first time he ever performed an internal surgery. He's done 2 or 3 internal. Also, do you still have the stabbing pain in the back of your throat? I do. I'm hoping they are just phantom pains.

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Sorry, I meant that this was the surgeon's first external surgery.

Mare said:



So Cal Char said:

Hi Mare,

I just had external surgery on July 17, 2014 in San Diego, CA. It's about 3 weeks post-op now. I was on oxycodone for about 10 days, and I also asked for a muscle relaxer and a non-steroid anti-inflammatory. Those both helped, but I am still in terrible pain when I'm not taking anything. The worst is that there is this big lump around the incision. Did you experience that? Also, did you find out how much of the styloid was removed? My surgeon said he only removed 2 cm. That doesn't sound like enough. Selaness80 had 4 cm removed from the internal approach. I thought the external was supposed to remove more. By the way, this was the first time he ever performed an internal surgery. He's done 2 or 3 internal. Also, do you still have the stabbing pain in the back of your throat? I do. I'm hoping they are just phantom pains.

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Hi So Cal Char,

I thought I posted a reply to you yesterday, but I can't find it, so excuse me if this is a duplicate response:

I am still having a slow recovery 18 days post op left sided external surgery. My temporary left lip paresis has not resolved (mandibular nerve trauma), and neither has my left ear, jaw, neck numbness, tingling and burning (greater auricular nerve trauma). But, I can tell the styloid bone is gone so I can move my neck better (no more scraping stabbing ear pain), but since I still have swelling, pain and stiffness, it's hard to know what the real outcome is yet. My surgeon said the styloid was very prominent and very long and that he expects me to have some relief. He said he cut it down all the way to my skull. I am going to ask him if he measured the length of the bone when I see him next week.

I am still having to take 5 mg of hydrocodone for the incision and neck pain, but only 1 or 2 times a day now. The pain is worse if I am up doing normal activities of life, just moving, walking, and talking, etc. My incision is tight and pulls on the left side when I rotate my neck. My incision is still firm and swollen like yours. It is improving some but is still very sensitive and if i press on it, or my collar rubs it, the burning nerve pain gets stirred up. I also still have some occasional throat pain, but I think it is due to the glossopharyngeal nerve being aggravated during the surgery and should resolve with time. I see my surgeon for second post op visit next Wednesday. I hope to learn what to expect from here, and should have a better idea by then if I am going to be able to return to work any time soon. This is a big surgery with lots of nerves and blood vessels to work around and aggravate! I am trying to stay positive and hope that the elongated styloid actually was the source of my pain. I have other neck issues too (hyper-mobility of neck ligaments and some cervical spine arthritis), but doctors said that was not causing the type of pain (Eagle sx) that I was having prior to surgery. Time will tell... One of the many things I am learning from this disease, is to HAVE PATIENCE AND HOPE. I am "hanging in" like all of us with Eagle syndrome do!

I hope you continue to feel better every day. Take care,

Mare

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