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Eagle's Syndrome case: 25y.o./Female - 8 months post-op adenotonsillectomy

Oct 14, 2009 - 3 comments
Tags:

eagles' syndrome

,

Eagles

,

Eagles Syndrome

,

chronic otaglia

,

ENT

,

3D cranial CT scan

,

throat pain

,

tonsillectomy

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oversalivation

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chronic neck pain

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Neck pain

,

TMJ



Just want to share my case with other sufferers, and share in thier experiences as well.

My title tells you I had my tonsils and adenoids removed 2/2009 due to chronic (low-grade) bacterial infection. Major complaints were of pain on LEFT side. Surgery was unremarkable, recovery saw an isolated incident of hemorrage; one week post-op left side tonsillar arch bled for approx. 5 minutes. Recovery was also unremarkable and I was fully functional 4 weeks post-op.

Approx. 10 weeks post-op discomfort presented with stinging and burning sensations in oral cavity and down into pharnyx on right side, sinus and orbital pain, oversalivation, ear discomfort including itchiness, a moist feeling in the ear canal, and chronic otaglia, tongue, jaw, and cervical (neck) pain ALL on  the right side. Also, a new sensation of a difference in functionality when swallowing appeared (left side feels normal, right side feels impeded w/ foreign body sensation).

The preceding symptoms have waxed and waned throughout the last 6 months. Seperately I was diagnosed with costochondritis on the same side, which could be a contributing factor in cervical pain. I also got a differential diagnosis from a dentist, ruling out the possibility of an infection, impaction, etc. I thought possibly TMJ was a factor due to the jaw pain, though this is unlikely as the TMJ is not where my pain is radiating from nor do I hear the typical clicking/grinding sounds of TMJ. Additionally I have a lateral crossbite, sever crowding and malocclusion which will eventually require orthognathic surgery, and this causes me to have episodes of trigeminal neuraglia on the right side. Been dealing with that for years and so I have differentiated those pains from those of this Eagle's.

The most pervasive and continuing symptoms are the cervical and ear pains, and the foreign body sensation/swallowing sensations.

I consulted with an ENT 8/4/2009 who examined my ears, attempted to palpate any cervical lymph nodes that may have presented (none did according to the Dr., though I have one on the right I can palpate any time, and it was/is of concern to me, though many doctors have tried to feel this for me and none have found any indication that there is a problem here; I noticed the node even before the surgery for tonsils and it has not changed by any measure for 10 months). He also examined my nasal cavties and throat/vocal cords by way of a tube through the nose (not sure what they call this procedure) and this exam also produced no findings.

The attending doctor was knowledgeable enough to suspect Eagle's after this first exam. He was aware that I had been seen several times in the preceding 4 months by emergency clinicans for this problem of chronic ear/throat/neck/sinus pain with no findings nor relief from previous treatments (antibiotics for possible infections, sinus steroids, more antibiotics, sinus CT scan). He and the resident attempted to palpate the styloid process through my right tonsillar fossa, and this did recreate my pain, but they were unable to feel a protrusion. They requested a cranial CT with 3D reconstruction to measure the length of my styloid processes.

The CT came back and I have a 2.4cm styloid process on the right side. They did not tell me how this compared to the left side, though from the image it did appear the the right side is, though not a great deal, longer and bigger around than the left side. The gurth of the right process as compared to the left is what stood out to my untrained eye; I'm curious as to whether this is a sign of ossification/calcification of ligaments attached to the process.

Preliminarily, the doctors prescribed Gabapentin 300mg/day until the next appointment, to see if this could possibly offer relief and an alternative to surgery. I have yet to start taking it. I am in a mild-moderate amount of pain every single day, and at the time of this writing,  it seems to be worsening. Will update soon.

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by steven525, Oct 25, 2009
Hang in there, hope things are getting better. Thanks for keeping us up to date.

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by ronr, Feb 20, 2011
What is the outcome of your surgery?

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by sovereignic, Feb 20, 2011
The outcome of the adenotonsillectomy was successful except for the Eagle's. I have yet to have any other treatment, I did not take the Gabapentin, and my Eagle's symptoms have improved significantly on their own, though occasionally I do get slight right side ear and/or neck pains.

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