Finally, after red tape and kidney function tests, I have a private CT scan with contrast scheduled for next week. They are looking specifically at my SP’s measurements and angle. Is there anything else I should be requesting them to look at in the scan? Any advice I can get to get as much info for the ENT is greatly appreciated. I desperately need a diagnosis and a path to resolution. Thanks everyone.
I’m so glad you finally have your CT appt scheduled! Please make sure they also check for any calcification on your stylohyoid ligaments. Sometimes there’s only a small amount in addition to elongated styloids & sometimes the styloids are fine & only the ligament(s) are calcified & sometimes the styloids are elongated & there is significant calcification of the ligaments as well. Checking both styloids & s-h ligaments is critical.
If they’re elongated, then if they could look at the angle & gap between the styloids & cervical bone processes too, there have been members with a narrowed gap, which can squeeze structures.
Thank you for your input, I appreciate it.
YAY! I finally have my new ENT referral appointment January 2020! I had my private CT scan done last week, I included all the advice I have received from @Isaiah_40_31 and @Jules in the CT requisition. Checked with the new ENT office and my file with scans and report are sitting on his desk for review, I have been given an appointment for January 21 and I am ecstatic to finally sit in front of a doctor that knows about ES. I want to take this opportunity to tell fellow ES sufferers, don’t ever give up, keep advocating for yourself, listen to others that have walked this journey; I am onto my 10th medical professional, 4 years 8 months later. My symptoms continue to worsen as time goes on, hopefully, I am only a month away from a diagnosis, I have hope again…never give up. Thank you for all the support, you have no idea how much it has meant to me when doctors and even family and friends looked at me as if I was a crazy person. Thank you @Diasy for never giving up and finding Dr. Dan O’Connell in Edmonton, you have pointed many others in the direction of relief! Wishing you and yours a Merry Christmas and a Happy New Year!
I haven’t posted in a while…been trying to catch up on everything this afternoon and ran across your post! So glad you finally have an appointment to look forward to. I will be anxious to hear how your appoint goes come the end of January. Despite experiencing symptoms for many many years and having seen doctor after doctor, dentist after dentist, I was only diagnosed in April of 2018. A 3-D dental panaramic xray told the tale. Since then I have seen a couple of so called ENTs interested and/or experienced with ES only to find out they really aren’t all that. I am currently recovering from cervical spine fusion surgery and plan to address the ES again when I am fully recovered from that. I’ve been on that crazy train too as have most of us here. Ups and downs are part of this journey…but knowing what you are dealing with and feeling hopeful again is everything. People here are amazing and I am so happy you have found much needed comfort to carry you through this! Cheers to you and yours and I have a feeling 2020 is going to be a very good year!
Thank you @kiZe6159, all the best to you and yours!
That is wonderful news! I will be praying for a productive appointment that starts the wheels in motion for resolution to ES for you!! Hope is a wonderful Christmas gift!
I wish you a very Merry Christmas & blessed New Year which includes healing from ES pain & symptoms.
I bet you do have some catching up to do after the major surgery you just had. We’ve missed you on here. I hope your recovery is going well & you’re able to take the next step & deal w/ ES earlier than later in 2020. I agree, 2020 will be a very good year & am praying it also sees an end to ES symptoms for you.
Not long now! I hope he’s helpful after that long wait, you’re on my prayer list!
Hi everyone, I’m less than a week away from my new ENT appointment, I’m terrified I’m going to get another brush off and the “I can’t help you” speech. I now have my radiologist report from my private CT, I apologize in advance for the length but would like your opinions on the following report, which I fear may not bode well for an ES diagnosis for me: “The right styloid process measures approx. 3.0 cm in length. The left styloid process measures approx. 2.9 cm in length. They both measure approx. 4mm in thickness at their bases and taper gradually inferiorly. On axial images the gap between the right styloid process and the right C1 transverse process measures 6mm and the gap between the left styloid process and left C1 transverse process measures 5mm. There is unchanged mild flattening of both internal jugular veins. No mass effect on carotid arteries. There is no calcification of the stylohyid ligaments. Using similar anatomic landmarks, these measurements are unchanged from March 2017. No discrete mass in upper aerodigestive tract. Incidental bilateral palatine tonsilloliths…(theres more but I think this paints the picture) IMPRESSION: Borderline mildly elongated bilateral styloid processes. This can be seen in normal asymptomatic patients. Eagle Syndrome should only be considered in the appropriate clinical setting.”
I have had symptoms since 2015, 4.5+ years 10 doctors, dentist etc. trying to get a diagnosis, all my previous CT’s/MRI’s focused on other areas (TMJ’s etc) so no specific comments about my sp’s, no previous mention of palatine tonsilloliths on reports from previous scans. My pain and symptoms continue to get worse as time goes on I am essentially housebound now, and desperate for a resolution. Nothing seems to take the pain and head pressure away, my dizziness and balance are really bad, I just feel terrible all the time. Your thoughts on the radiologist report would be appreciated. Thanks.
The report does say that the styloids are mildly elongated, not sure what they mean that it ‘should only be considered in the appropriate clinical setting’- the definition of ES is elongated styloid processes causing symptoms, so it does fit, but unfortunately there are alot of more conservative doctors who wouldn’t consider those lengths elongated enough. There are research papers which mention the ‘average’ lengths, & also the angle of the SPs. The slight flattening of the jugular veins is interesting- not sure if that’s enough to cause symptoms. Onelessstyloid & JustBreathe have posted links to research papers recently about jugular compression, I think there was mention about angles & gaps between the SPs & cervival vertebral processes. I’ll see if I can find them.
I hope that your appt. does go well , I will be praying for you…
I’m in Jules’ camp. Your styloids are elongated even if only slightly. I find the slight flattening of the jugular veins to be a little alarming as in my book that implies some compression which could be the cause of the vascular symptoms you’re having. Additionally, there have been several forum members who’ve been diagnosed w/ styloids of one length & after surgery were found to have much longer styloids than seem to appear on the CT scan so there’s that to consider as well.
As Jules mentioned, styloid angle can play a significant role in producing symptoms as well as thickness & how pointed or twisted the styloids are. It is good that you have no ligament calcification.
You can use the magnifying glass icon to search for the research articles that Jules mentioned. Type in onelessstyloid or JustBreathe in the search box & a list of posts will come up. It should be relatively easy to find the research links.
I will also pray that you will be received well by the new ENT.
Thank you Jules!
Thank you Isaiah!
Here’s the link to where JB posted the research paper. It quotes an average of 2.9mm gap between the SP & C1 lateral process in those patients with Intracranial Hypertension related to ES, vs an average of 9.9mm in a person without ES. So if yours are 5mm & 6mm, they’re a smaller gap than the average person, although not quite as narrowed as those in the research paper, but could account for the slight flattening of the jugular veins, & some vascular symptoms. Might be worth taking a copy of the paper with you?
If the doctor is hesitant, maybe you could ask about testing to measure your Intracranial pressure as you have symptoms of Intracranial Hypertension?
Hope this helps a bit…
Thank you so much @Jules, this is very helpful. I appreciate your support, I will post later next week on how everything goes.
Hi everyone! I had an extremely emotional day yesterday, but good news, I finally got a doctor to listen! He said I have classic symptoms of ES although my SP’s aren’t as long as usually presented in ES (2.9 & 3). I thought here we go, another brush off is about to come, but he continued to tell me he looked at my scans and that my SP’s were “a strange shape, especially the left (symptom side)”. He is going to remove the left SP intraorally, hopefully within 3-6 months. He did tell me that there is a 50/50 chance it will resolve my issues and that I may have permanent nerve damage, he will start me on a medication regimen after surgery to help the nerves repair. My journey is far from over, but the relief I felt when he told me he would do the surgery and would not turn me away without trying to help, well that was it, they water works started and I couldn’t stop. He was such a relief from all the other doctors I’ve seen (he was dr. #10), he touched my shoulder and told me to hang in there, I would get surgery as soon as it was possible.
I want to thank everyone on this forum for all the advice, support and simply listening as we all go through this ES journey; connecting with others going through or have gone through the same thing gave me the strength to move on and continue to advocate for myself and believe that I indeed was not crazy. I will be forever grateful, bless you all. For those still struggling to find a doctor to listen, don’t give up, keep on advocating for yourself, however hard it may be, you are the only one who is going to fight for you.