I had bilateral styloidectomy in December with Hackman. No change in symptoms. I do have an appt with Hepworth in September (so thankful) but wondering if anyone else has needed a c1 shave after the first surgery? Thank you 
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The answer is yes. I’m scheduled for IJV decompression w/ Dr. Hepworth at the end of October. I had my first & second ES surgeries in 2104/15. My IJV compression problem took me 8 years to discover. That’s pretty sad considering I’m a moderator on this forum!! 
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Did you have any symptom relief from styloidectomies? What did Hepworth use to figure it out? If you did it with him the first time, why didn’t he do c1 resections? Is he scheduling three months out for surgeries? Lots of questions but I think this may be my issue too 
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Here’s my ES timeline:
9/2014 - Sent for a CT scan by ENT due to neck pain & hard lump under the left side of jaw which showed up several months prior. Diagnosed w/ bilateral ES.
11/14 - 1st styloidectomy - rt. styloid. Dr. Samji was my surgeon. I had some symptoms relief, but symptoms from the left styloid remained & got worse.
5/15 - 2nd surgery scheduled, but I had a cycling accident w/ a head injury 1 week prior to surgery date which delayed surgery by 3.5 mos.
6/15 - Vascular symptoms started about a month after the cycling accident, but I didn’t recognize that’s what they were. I was diagnosed w/ Meniere’s Disease based on the symptoms which included horrific tinnitus, hearing loss, brain fog, & vertigo.
8/15 - 2nd styloidectomy - brain fog was reduced & nerve pain caused by left styloid went away over a period of 6-12 mos. Tinnitus, hearing loss, & vertigo remained & got worse.
2/19 - I had an endolymphatic sac shunt deep in my left ear to try to save my hearing which began a rapid decline in 1/19. The shunt helped stabilize hearing for a couple of years then it began to decline again.
2021 - I received a medical research article which suggested Meniere’s hearing loss can be related to IJV compression, & decompression surgery can restore hearing to at least some degree, so I began my quest to find out whom to see to get the scans I needed for diagnosis. My ENT referred me to an interventional radiologist who sent me for a CTA (2/22), dynamic ultrasound of my IJVs (2/22), & an MRV (12/21). All my results came back negative for IJV compression, HOWEVER, I learned from this forum to be proactive about confirming that what the radiologists report is accurate, so I uploaded my images here & learned from one of our members that I indeed have IJV compression, bilaterally. My journey w/ Dr. Hepworth started after I had confirmation of what I suspected. I saw him in 2/24 & have surgery scheduled for the end of October.
It’s possible he’s scheduling 3 mos out from now for surgeries. I called near the end of July & was given 10/30 as my surgery date.
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Praying this is it for you.
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I’m sorry that you still have symptoms after your surgery, but pleased that you have an appointment with Dr Hepworth. I know @KoolDude had a C1 shave after his styloids were removed although his symptoms haven’t resolved I believe…
This discussion might be helpful:
CT Scan Pics, broken styloid or scan error? Compression? - General - Living with Eagle
There are other discussions, you can use the search function to look them up…
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Here is another one!
I should’ve had styloidectomy in 2018 but they did surgery for hyoid bone syndrome on me.
2019 they did half way styloidectomy and left abt 2.4 - 2.5 cm inside compressing the jugulars.
2021 i saw a doctor in CA who resected more of the left styloid but couldn’t resolve jugular compression. I had some relief of pain symptoms.
2022 I’ve had styloidectomy on the right side in Denver with resection of strangulating scar tissue around the jugular vein, followed by balloon angioplasty. That gave me some more relief.
This Feb I had the left side done in Denver again with styloidectomy, TP C1 shave, resected scar tissue and implantation of a myriad membrane around the jugular vein.
That gave me a big relief. Accordingly, blood flow velocities decreased from above 100cm/s to about 40cm/s now.
If you haven’t already I’d suggest to have an ultrasound done by the Hepworth’ Protocol:
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If both sides of c1 need shaved does Hepworth make you do two surgeries?
@JSwing - He does not do bilateral decompressions in one surgery. You’ll need a 3-6 month healing period between surgeries. I have a hole in my skull from a previous intervention for my hearing loss, & he wants to fix that, but told me be he won’t touch it till 6 mos after my decompression surgery in Oct.
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