@GiannaM - I watched all 3 videos you linked & strongly disagree w/ Dr. Centeno on most of the points he made.
1st video - ES diagnoses are not 'pulled out of thin air" as he suggests. They are the product of a doctor learning about a patient’s symptoms, referral for a diagnostic CT scan, & revelation of one or both styloids being elongated &/or stylohyoid ligaments being calcified, with the existing symptoms being known to be caused by ES. Some doctors who are familiar with ES know the multitudinous symptoms it can cause whereas others confine ES to only a few specific symptoms & thus under diagnose it. I suggest that Dr. Centeno is in the latter category. I’d also like to know on what evidence he bases the statistic he gives that it’s 20x more likely the symptoms present when a styloid is elongated are not related to the styloid elongation. He goes on to suggest getting specific testing for other possible symptoms causes which quite a number of our members have done only to come back to the fact their symptoms are likely caused by their styloids.
If you haven’t read the list of symptoms ES can cause which @Jules put together plus her post about the styloids which she backs up w/ links to medical research papers in many cases, they will be enlightening for you:
The only cranial nerve Dr. Centeno mentions as being a cause of ES symptoms is CN IX - the glossopharyngeal nerve. He also only mentioned ES as causing neck pain. We have documented evidence that an elongated styloid is able to irritate 5, & potentially 6, other cranial nerves i.e. CN V - Trigeminal, CN VII - Facial, X - Vagus, XI - Spinal Accessory, XII - Hypoglossal, & possibly VIII - Vestibulocochlear. He also mentioned internal jugular vein compression somewhat lightly (3rd video) but failed to mention carotid artery compression which can cause a stroke.
2nd video - Having a styloidectomy has NOT been consistently demonstrated to make CCI worse. In fact, there are a number of other doctors who argue that the styloids play no role in cervical spine stability. The spine is firmly supported & stabilized by many small & larger muscles, tendons, ligaments, & fascia so instability can be a function of muscle weakness brought on by poor posture, injury, or disease (EDS for example), & an elongated styloid is thus not a supportive structure that stabilizes an unstable cervical spine. It’s more of an adaptive response on the body’s part for what it detects as instability. However, that adaptation i.e. styloid elongation/stylohyoid ligament calcification ends up causing more problems than it helps. In many cases, as the styloid(s)/calcified s-h ligament(s) grow, they bump up against, or can tangle with, the cranial nerves & critical vascular tissues I’ve listed above.
Normally a person doesn’t experience irritation of all 7 of the suggested nerves. Most frequently there is irritation of the trigeminal, facial, glossopharyngeal, vagus & spinal accessory nerves. These nerves cause diverse & far reaching pain or other uncomfy symptoms w/in the body which can worsen in different head positions as the styloid(s) increase pressure on them. That is not to say that CCI can’t also cause similar symptoms to ES, but in light of the fact we have so few members who’ve benefitted from alternative therapies such as prolotherapy, PICL, & stem cell injections, & later had styloidectomies which were beneficial, I suggest that styloidectomies are potentially the more reliable solution to the symptoms.
3rd video - Dr. Centeno asserts the fact that when a person has IJV stenosis on imaging it “doesn’t mean much”. The question he was answering was asked by a person w/ <50% IJV stenosis who did have symptoms we know via medical research can be caused by that stenosis & ES, so I question why he’d comment up front that it doesn’t mean much on imaging. Agreed there are people who have stenotic IJVs that are asymptomatic, but people who find their way to our forum & to Dr. Centeno are desperate to understand the cause(s) of their “crazy” (as he put it) symptoms thus are not asymptomatic. Whether caused by CCI or elongated styloids/calcified s-h ligaments, IJV stenosis on imaging is significant, not insignificant as he suggests. Additionally in answering the person’s question he suggests that standard ES only causes tinnitus & back of the throat pain (caused by CN IX) & not neck pain which is ABSOLUTELY wrong! Many of our members have neck pain from ES that has nothing to do w/ CCI.
I don’t know whether what I’ve said will further “muddy the waters” for you, but I hope it gives you a new perspective based on my experience on this forum for the last 11 years.
I believe CCI can cause IJV compression, but in my experience here, it also possibly causes styloid elongation which causes symptoms that only a styloidectomy can resolve.
Dr. Centeno further said that once the styloid is removed it’s harder to for the his procedures to help reduce cervical instability because he suggests that the styloid has played a key role in helping keep the cervical spine stable, & once it’s gone, the support it provided is no longer there. He also said that when CCI is successfully treated the symptoms which had been blamed on an elongated styloid go away so a styloidectomy is no longer necessary.
I profoundly disagree w/ those statements as we have had members over the years who’ve had elongated styloids & CCI. Preliminary alternative therapy for CCI has cost them thousands of dollars & provided no results, but upon learning of their ES diagnosis, & then having styloidectomy surgery, the symptoms reduced or fully disappeared. That’s not to say the CCI & ES don’t have symptoms in common, but ES can cause neck pain, & other symptoms that he also associates with CCI.