Will a CT scan for a separate issue provide clue?

I posted my dental x-ray back in May looking for ideas about the length of my SP after my dentist declared that I had unusual calcifications on my panorex. Anyway, I am going for a CT scan on Wednesday for “mass” on my left parotid gland unrelated to my left elongated SP concern. I will have the scan with and without contrast. It is a Maxillofacial CT scan. I am curious if anyone is familiar with this CT scan and wonder if I might get some better views of my SP by chance? Hoping to kill two birds with one stone but my PCP is mainly concerned with the pea sized lump in my left parotid gland. Thanks for any thoughts!

I’m not familiar with what exactly they’ll do just for a max-fac scan, but guess that if they do the scan from the front or the side then it will show the styloids, just like the panorex did. If they look head down at all the sinuses then maybe it won’t. (If you google images for max-fac CT scan most show front and side on) If there’s any way you could talk to the radiography team about this before the scan it would make sense while you’re having the radiation of a scan that they evaluate the styloids at the same time. Perhaps try to get a copy so that you can look at it yourself?
I hope that it goes okay, and that there’s nothing to worry about in the parotid gland. Let us know how you get on!

Thanks Jules! I will definitely ask the radiologist about the SP and hopefully I can get a copy!

Just a suggestion - ask your PCP to include a look at the styloids along w/ the request to view the parotid gland. My experience dictates that asking the radiology tech will only result in him/her telling you that he/she can only do what the PCP ordered & nothing more. This will result in you having to go in at a later date if you want to pursue a CT scan of your styloids.

I hope this is helpful info.

Thanks Isaiah. I will ask her and maybe ask if they can look at my lacrimal glands too while they are “in” there since I don’t make any tears. I wasn’t sure if the scan would only show the parotid lump or the entire head. I know they are only trying to determine what the mass is but I was hoping these other two issues might be discovered as incidental findings. But now I’m thinking the scan won’t show more than the mass? If I get a copy could I bring it to an ENT and they can read it to check the SP? Or an ophthalmologist to read the lacrimal gland? I am very concerned about the mass but I just thought that maybe these other issues might be illuminated too. All these issues seem like they could be related…or not. I really don’t understand what the CT report or scan itself will even show. I will ask my doctor but I’m worried I won’t hear from her due to the upcoming holiday before my test. Thanks for the support!

I get dry eyes too- would be an idea to get that checked out, you can get prescriptions for eye gels to lubricate the eyes, if you haven’t already. Is your mouth dry as well? Sjogrens Syndrome can cause dry eyes and mouth, and often can cause stones and blockages to form in the salivary glands… they can do blood tests to look for inflammation and markers for Sjogrens.
I have dry eyes and mouth too- I did wonder if the nerves supplying the eyes could be affected by styloid process compression ( a branch of the Trigeminal Nerve goes to the eye, and the TN can be compressed and cause pain), but apparently it doesn’t have any motor function. Anyway, it would be an idea to get it checked out if you haven’t already.

Thanks Jules! I have had two negative Sjogren’s blood test the last two years when all my issues started. My rheumy ran a battery of test and all normal! I have Hashimoto’s with normal TSH but it fluctuates so I’m on and off meds over the years. Endo said dry eye and pain unrelated to thyroid disease. Eye Dr say eyes look fine but I’ve tried Restasis and failed miserably for 15 months, been on Xiidra and it helps a little. Over the counter drops irritate more. I have mild dry mouth according to my dentist and no dental issues. My main issues are related to POTS but nobody can explain if that relates to my eye issues. So, at this point just looking for a needle in a haystack hoping to explain what the heck is going on. Now with the parotid “mass” -it does not cause any swelling (seen in Sjogren’s and sarcoidosis or infections, etc) and is very discrete but the location is where all those wonderful facial nerves branch off. And it is my left side near my possible elongated styloid process. Thanks for the support! Hoping CT might help me piece some things together!

A CT probably won’t give good info about your lacrimal glands unless you have calcifications there. CT scans are just a glorified x-rays. Although a CT with contrast might show something. An MRI (don’t even know if they do those for eye things) or some type of test that shows what’s going on in soft tissues would likely be more helpful.

I believe even ENTs rely on the reports radiologists send w/ a CT scan to so they can give accurate info to you. However, I would expect an ENT doc would be able to recognize an elongated styloid or calcified stylohyoid ligament even without a radiologist’s report.

I hope you’re able to get everything done at once so you can begin working on taking care of the things that are making you uncomfy!

I’ll pray for that.

Thanks again Isaiah. Hopefully my doctor can add to my order in time! I showed her my panorex and pointed out the SP but she was concentrating on the area where my mass is (which showed nothing in the area) which seems that whatever the mass is, it’s not calcified. So I asked her if it would even show up in the CT and she said everything will show up, not to worry. She didn’t want to bother with an ultrasound as she felt it would be indeterminate. I believe I would have to see a very experienced ENT if this mass is a problem so hopefully, if it comes to that, I could get some answers sooner or later!

Sounds like you’re being kept an eye on… but so frustrating when no-one can come up with the answer. We’ve had a couple of other members with POTS as well and there does seem to be a lot of members with thyroid issues here… not sure if it’s just co-incidence/ better diagnosing with some things or not. Hope that you get some answers with your CT.

How are you doing these days? What became of your parotid “mass”? Have you gotten any answers from the testing you had done? Please update us when you have time/feel up to it.

Hi Isaiah,
The CT scan did not show anything unusual in my parotid in spite of the bump that can be felt. My PCP felt good about this and told me she is not concerned but if I wanted I could go to an ENT. She did not have any idea about my Panorex X-ray and was not concerned about the length of my SP. her only focus was the lump. The CT claimed everything was normal except for thyroid nodules which I already know about. So, I’m not really sure what to do. I don’t have any answers but am very glad to know the parotid is healthy. I could pursue the ENT to find out what the lump actually is and ask about the SP on my panorex but my PCP really didn’t think it was necessary. I am seeing a geneticist in October regarding possible Ehlers Danlos causing my POTS so might wait until after that appt. I’m assuming they would have seen compression or vascular issues on the CT that might contribute to my dysautonomia issues? I’m not too sure how to proceed at this point but thanks for checking in!

If you had a normal CT, as opposed to a CT with contrast where they inject a dye into the veins, then it wouldn’t show any compression of blood vessels by the styloid processes. If you can get it converted into 3D, (if you can get a copy of the CT there’s instructions on here in the ES Info section about how to do that) then sometimes you can see other structures better.
We’ve had quite a few members with EDS as well as ES on here recently.

I had it with and without contrast. How would I go about getting a copy of it? Thanks for your help!

Hi Serenapuff,
Thank you for the update. It sounds like you still have a bit of “discovery” ahead of you. I hope all goes well for you & you get some solid answers.

You can get a copy of your CT scans by requesting them from the radiology clinic that did the scans. They will probably give them to you on CDs. You can also request a copy of the radiologist’s written report. Some places charge for the CD copies & others will just give them to you.

Glad to hear that your parotid gland is fine. There are occasions when the styloid process(es) can protrude & be felt in the area where the parotid gland is. I’m not saying that is your case, but the styloids are crafty characters & can cause problems even if they’re not excessively long but are angled oddly or are thicker than normal. Also, the styloids themselves can be no problem, but calcified stylohyoid ligaments can create all the symptoms of ES. My personal opinion is that it would be worth it to see an ENT who is familiar w/ ES & get an opinion. ES can cause all sorts of symptoms that mimic symptoms of other diseases/syndromes. It’s not until the styloids/ligaments are removed that one can know for sure what symptoms they were specifically causing.

I hope your scheduled tests & doctor visits provide you with useful & helpful information.

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Hi again-it has been awhile! Just wanted to follow up now that I finally took the time to follow the directions to convert my CT scan from last year to 3D. The tutorial was wonderful-big thanks to the member who provided the steps! So I have a new question. I am curious if anyone knows if elongated styloids are related to parathyroid issues? My annual thyroid scan showed a possible parathyroid enlargement which My endo is further investigating via bloodwork. Knowing that parathyroid glands control calcium I wonder if there is a relationship between hyperparathyroidism and ES in general? Also, I will post a picture of my 3D. Still not sure if it’s technically elongated. I don’t have any sign of one on my right side.

There have been members on this forum who’ve had parathyroid disease but whether or not it’s directly related to ES is unclear just as tonsillectomy, neck injury, thyroid disease, etc. may be related, no one has diffinitively found a link though I’m not sure anyone has even really researched any of these as related to Eagle Syndrome. In some cases there has seemed to be a hereditary component but this isn’t true in every case.

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WOW! Your styloid looks like a corkscrew. Kind of neat!

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Obviously we’re not doctors so can’t say for definite, you’d have to speak to your doctor about the scan, but the styloid process does look quite long. The angle can be quite important too, difficult to tell, but the end looks quite pointy, which at a guess may well be irritating structures around it.
As Isaiah says, there have been quite a few members with parathyroid issues- I did find mentioned in research papers that metabolic disorders could be a possible cause for ES, so I guess the calcium issues could come under that.
Good luck with your journey…

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