Hi all, still waiting on official diagnosis but I do have elongated styloids. I recently started seeing an upper cervical chiropractor (I know chiros can be very controversial) and I’m feeling a lot of soreness and pressure in the soft tissue below the jaw bone (highlighted in red in the picture) anyone experience this? Maybe it’s swelling from my adjustment?
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I’d also like to ask- I have an appointment with Dr. Costantino in June however my CTA is from 2023. I’m having trouble getting my pcp and local doctors to listen to me but I’m wondering if I would need a more recent CT scan?
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@kiwi - Yes, it would be ideal for you to get an updated CT since the styloids can keep growing.
You’ve got a pair of pretty gnarly looking styloids. The left in particular is long & thick & the right one is long & slightly curved. Both look fairly close to your C1 vertebra. The greater horns of your hyoid also look like they could be a bit long. Something else to discuss w/ Dr. Costantino when you see him.
As is the case with so many of our members, your cervical spine has lost its natural lordotic curve. This is called military neck & curve loss brings the styloids & hyoid closer to vascular & nerve tissues in the neck. There are gentle exercises that can be done to restore the curve, but it takes patience & time for that to happen. Since you’re working with a cervical chiropractor, you may want to address loss of cervical curve & ask for suggestions about how to restore it. Sometimes it’s best to wait until the styloids have been dealt with before starting on that project though. Here’s a good post w/ some information about military neck & how to “fix it”: List of my favourite resources on YouTube to learn anatomy
Regarding the pain under your jaw after your adjustment, it might be best to put adjustments on hold if you aren’t getting relief. You already have enough symptoms making you uncomfy so adding to them is going in the wrong direction.
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If you are able to get a new CT done I agree it would be helpful, although the images you’ve posted certainly show that you have elongated styloids! If you did get a scan and can have one with contrast, then ask for it to be timed to show the arteries and the veins, CTA/CTV, it is possible for them to do both & it would show clearly if there’s any vascular compression…
It could be maybe an irritated lymph node in the area you’ve marked? But I agree with @Isaiah_40_31 that if you’re not seeing any benefits it might be a good idea to give it a miss.
One of our members wrote a paper aimed at chiropractors doing neck adjustments in case you wanted to show it to your chiro?
WESTBROOK et al. (2020) - Eagle’s syndrome, elongated styloid process and new evidence for pre-manipulative precautions for potential cervical arterial dysfunction – Doctor info and research article - General / Research Papers - Living with Eagle
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Thanks for the feedback! My problem is that since my CTA was reported as normal my current doctors don’t feel like I need a new one done 
but I will look into those resources thank you!
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It’s not the end of the world if you can’t get one as your CT does show the styloids well…
But we do find that often CTs are reported as being fine when clearly they’re not, so Dr Costantino might see something on them anyway!
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I got my CBCT results back and unfortunately they didn’t measure the length of the styloids but rather the distance from c1. Left side distance from ossification to C1 within 1.5 mm on left and 5 mm on right
@kiwi -
1.5 mm means your IJV is nearly completely squashed on the left, & the right has more normal spacing between the styloid & TP of C1 so the IJV isn’t compressed. That doesn’t mean the situation on the right doesn’t change with head turning though.
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If you want a basic overview of spinal conditions such as CCI, Chiari, etc. then this video is quick and informative. Dr. Patti Sullivan at Brown University explains treatments and symptoms, so would be helpful for ES patients to at least understand what their chiropractor or neurosurgeon is evaluating.
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Very interesting video, @jobby99. Thank you for sharing the link.
Thanks for posting this! Have you seen her yourself?
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