I’ll ask the moderators to chime in here, as my school of thought is solely based on my personal experience and not based off true expertise nor decades of cases assessments. <3
Kmarty14:
- Does potentially knowing the cause of the ossification affect which surgery or surgeries I get and in what order?
To some degree, it’s like asking what came first, the chicken or the egg. At the end of the day, you have ossification in an area that is resulting in complications, i.e., vascular impingement. The only benefit to knowing the possible cause would have been preventative care, which unfortunately we are all past on this forum.- Do I really want to even consider getting my jaw cut in half and screwed into a new position while potential styloidectomy is still a variable?
I don’t see how a styloidectomy is entirely avoidable. I would correlate this to a foundation defect. It makes the most sense to me to align the neck (as the foundation) before aligning the jaw. My experience is a bit backwards, as I had my jaw fixed prior to the neck abnormalities. So, did the jaw surgery cause it, or was it inevitable given the skeletal defect?- What are the risks or obstacles of trying styloidectomy first? (Pretty easy answer there. It’s more expensive and harder to find a surgeon for. And, in some ways, it feels riskier because of all the important structures in that region. Hence Dr. Osborne’s advice to me to try everything else before styloidectomy.)
Sadly, financial limitations can limit the quality of care patients are able to obtain. In the wrong hands, there is an array of serious complications that can occur. Given my experience with Dr. Osborne, I never felt at risk because of how incredibly qualified he is.- What ways do these interconnect? You mentioned no other way around vascular impingement. I have been wondering the same. But I similarly wonder if fixing my jaw (via either method) would open up room around the vessels? This is what I need to find a vascular Eagle specialist for.
Since sharing my story with an integrative orthodontist, she has uncovered that the majority of her patients have ossification that is resulting in common “TMJ” symptoms. For a large majority, alteration of the jaw alignment has opened up space and helped alleviate some symptoms. However, the other half of the patients don’t obtain full resolution because, until now, they were unaware that the true diagnosis was indeed Eagle syndrome. (Again, her theory is that if the jaw isn’t aligned, ossification will return—accurate only if the full ossification isn’t properly removed.)
I was too young at the time to fully investigate the severity and classification of my case, so unfortunately, I can’t confidently assess your case and determine whether or not split therapy would be fully effective.
I would consider getting an assessment from other specialists, such as Dr. King, to get a clearer picture of what level of improvement or resolution could potentially be achieved without surgery. Recall that splint therapy is often utilized PRIOR to braces. The goal is align and grow the jaw properly so the teeth align naturally. ( without the need for extractions)
In my case, I wonder whether my underbite may have provided some degree of compensation. If my tongue had been able to adequately widen my soft palate, perhaps that, combined with the relatively minimal malocclusion, might have been enough to address at least some of the issues.
As you mentioned in your own case, you can’t add bone that simply isn’t there. That’s an important limitation to keep in mind when considering the different approaches.