Hello all! This is my first post. I am newly diagnosed with ES. I have not been able to find an answer to my question about the ligament resection. Specifically, I am confused about the consequences of removing the calcified ligament. Is the ligament rebuilt somehow? Do you loose any mobility because of the surgery? Thank you for any help!
Hi Duckie!
Welcome to our forum! The stylohyoid ligament plays a minor role in swallowing & isn’t missed when it’s gone.
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It’s best that calcified sections of ligament are removed as they can continue to rub against or compress nerves and blood vessels. If the ligaments aren’t calcified they are usually left in, detached at the styloid end during the styloidectomy of course, and don’t seem to cause any noticeable change!
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Ok, thank you for the answer. Do you know if the surgery usually requires blood transfusions? I saw one post op update showing drainage lines but another post referred to transfusions. Is it a really bloody procedure?
Those are JP drains. Bleeding is minimal, 25-50 ml unless something unexpected happens (I remember one member talking about his case when an IJV ruptured during the surgery, and the surgeon needed to create an emergency patch).
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@Duckie, if you’re feeling brave you can watch both intraoral & external ES surgeries on YouTube.
I was amazed at how “bloodless” the surgeries are. One of the surgical meds used is epinephrine which is a vasoconstrictor thus it helps keep bleeding to a minimum.
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I wondered that too…So the ligaments attached to the styloid are removed from the styloid during the surgery (or do they attach at the base of the styloid by the skull and are not messed with)? I would think that you would be in a world of hurt (plus loss of function) without those ligaments being anchored.
Also, does anything (styloid process or calcified ligaments) get broken off (in the course of life) and cause problems?
The ligaments are detached from the styloid, mine were certainly left in & I’ve never noticed any difference with speaking, swallowing etc. I don’t know why they don’t seem to affect anything, but it’s something we get asked alot!
Yes, the styloid can get fractured, we’ve had a few members who’ve broken theirs & that’s what has set pain & other symptoms off for them. It can be easily done sometimes, e.g. by laughing or a big yawn!
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That seems to be a crazy mystery. I’ll have to ask next time I’m in the office to see what they theorize. Maybe they need to be attached when we are younger/developing??
I think I have calcified ligament(s) too and wonder what will happen if one of those breaks (shatters?).
Hello @Duckie welcome to the forum!
I had a section 2-3 cm of calcified ligament removed recently
I have not noticed any difference in movement or chewing,
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@juliezuber - my ES surgeon told me the stylohyoid ligaments play a VERY MINOR role in swallowing & I wouldn’t miss them once they were gone. I can happily report, as did @Jules, that not having them or not having them attached to anything any longer, has not been noticeable for me.
Thank you! I appreciate the knowledge and real life experience. Thank you for sharing.
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So, Got both styloids removed with pars of both ligaments removed a little over 2 months ago…yay! I can happily report that it did what i needed it to do. I am not 100% pain free but I have my life back, and I can live with the pain and discomfort that remains.
As far as noticeable difference, i will say that my pallet is weaker now. I snore more readily and you can tell a difference in my voice of i talk too much. Now, is that because the ligaments are gone or because my surgery was interoral and the muscles are still healing? I dont know. I am doing exercises to strengthen the muscles regardless and am hopeful that things will get more stable as time passes and things heal.
I also noticed for about 2 months post surgery that the muscles in my face and neck would do this odd spasm/twitching routine. It was like everything was going through a checks routine and my nerves and muscles were trying to re learn where everything was. It was not painful…more amusing and curious than anything.
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What good news that you’ve gotten signficant symptoms relief already, @Duckie! I would say the symptoms you have w/ your palate are not related to the ligament removal but could be related to the intraoral surgery & post op swelling & nerve recovery that will be ongoing over the next year plus. Exercises for the muscles that you’re doing should help expedite your recovery. I fully expect you’ll notice those areas that currently feel unstable will get more stable over time as you noted.
Interesting about the facial muscle twitching but you’re probably right - your nerves, which had been irritated for some, were sorting themselves out & letting you know about it by causing twitchy muscles. I hope that doesn’t continue even if it’s not painful. I think muscle twitching can also be a sign of magnesium or other mineral deficiency. You could ask your doctor about that next time you have an appt. if it’s still going on.
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I am glad you also think the weakness in my pallet will resolve over time. Patience right?
The twitching stopped on ots own about 2 weeks ago. It was amusing and in no way painful. However, I am glad they stopped.
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So pleased that you’ve regained your life since surgery, that’s exactly how I felt after my first surgery 
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