Which surgery route did you have? Intraoral or extraoral?

I’m waiting to hear back from my ENT I’m more than likely will be sent out of state for this surgery he has only ever seen ES in two other people he preformed intraoral styloidectomies on both…After a Doppler it was discovered last week I have carotid involvement and not only that but I’m a mouth breather and he explained I needed this surgery to be done the extraoral route…which after doing some research seems to be safer and more successful with better visibility and less chance of a deep neck infection and well as the ability to cut out more of the styloid process leading to a higher success rate…I really am not concerned about the scaring just wanted to hear from others which route they took and what their experience was like?

Here is my scan

It definitely seems to be that with external surgery there is better visibility/ access to the styloids, so more can be removed. Most doctors make the incision so it’s in a fold of your neck (mine were behind the ear & a down the crease of my neck a little way, not visible at all now 2 years on), so scarring often isn’t an issue. Like you say, infection is thought to be less likely with external too. That said many members have had successful surgery intra-orally, & if that’s the only option as long as a doctor understands the need to remove as much as possible & to smooth off the end, then it’s worth having done.
I saw a skull base surgeon, that was the only way he did surgery, & I found that the recovery wasn’t as bad as I was expecting. He was able to take the whole styloid process off & it has made a massive difference to how I feel; the vascular symptoms have almost all gone!
Glad that your ENT recognises the need for you to see an experienced surgeon, hope you can find the right doctor soon.


I had intraoral surgery a couple of years ago and the Dr who performed it only cut the tip off due to the styloid process being in contact with the facial nerve. I got no relief and am flying to CA for a second surgery externally in 2 weeks with Dr Samji. I’m hopeful of much better results. If you get your CT scan on a disk, there are some directions on this site to download and use a 3D slicer program (free) to remove the jaw and get a good view of your styloid processes.

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D907, Dr. R Layton Runkle took out my tonsils through my mouth and then, he cut out my styloids on both sides through my mouth. It was a hard surgery but, I did okay.

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