This week I had a very encouraging consultation with Dr. Aghayev. He said I have the longest and thickest styloids he’s ever seen and I would need a longer incision. His approach is behind the ear and slightly down the neck. He’s fluent in multiple languages, does all types of neurosurgery, and did his residency in Tampa, FL. He seemed very experienced and said he does eagle’s/antlo-styloidal decompression regularly and has honed his technique. For example, when I asked about risk of scar tissue complication, he explained he developed a method using liposuction fat grafting from the stomach to transplant fat to the area of work after decompression to protect the nerves and vascular structure from the scar tissue formation. This sounds like a very good step for long-term success, and I will now ask the other surgeons about it in my next consults. I also asked about risks to nerves and if he does nerve monitoring to which he replied that is unnecessary and would be like using GPS for a commute to work because he will see them draped across the jugular once he’s in. He said temporary accessory nerve irritation/shoulder function can result but always resolves within a few months. He offered bilateral decompression, but I am probably still leaning to right side only at this time. I will be talking with Dr. Liu in 1 month and Dr. Constantino in 2 months, but right now Dr. Aghayev is my pick.