Author Topic: What happens if you're missing a couple of muscles?  (Read 490 times)

Dex1816

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What happens if you're missing a couple of muscles?
« on: May 31, 2023, 12:10:16 PM »
To cut a long story short, I may have to have a styloidectomy. I don't have Eagles Syndrome per-sae (in that my symptoms are debilitating), but it has been identified that my styloids are longer than usual and that some of the ligaments are calcified. I've had niggling neck problems for years and it has been determined that this is the cause.

It's a pretty simple and straightforward operation to solve it, but I'm intrigued as to whether this will change my adaptive response to having DJS. The stylohyoid muscle connects to from the styloid to the hyoid bone, and serves a minor roll in swallowing. To remove the styloid, these muscles, of course, have to be detached -- something that doesn't effect you ordinarily, but perhaps its relevant if you're having jaw surgery.

The muscle helps pull the hyoid bone up and back. Say theoretically I had this operation and then have no stylohyoid, and then had DJS. BSSO would cause the tension to change on all the facial muscles involved, so would this mean that I'd have less backward tension pulling in the opposite direction of the horizontal and ccw movement? And if this is the case, would that mean it might make the procedure more stable?

I thought this might be a possibility, but then I also thought that conversely maybe the hyoid would then come forward more after BSSO, considering there isn't as much force pulling it back because there's no stylohyoid. I don't know would be a positive or negative thing. The posterior belly of the digastric and the mylohyoid are presumably much stronger, though, so maybe it wouldn't make any difference.

Of course, I really have no idea and am just using layman's logic. I'll need to find out properly from a surgeon, but I thought some of you might have an idea as to how it works.

There is some literature on the topic, but it's very scant. Alongside the stylohyoid muscle (and a couple of other minor muscles that I don't think are relevant to this) there's also the ligaments that attach to the styloids, which would all be excised during a styloidectomy. One paper (https://pubmed.ncbi.nlm.nih.gov/22819693/) found that if one of the ligaments attached, the stylomadibular ligament, was removed, a BSSO procedure was more stable. That's the only instance of a positive effect of a styloidectomy on a future BSSO surgery I could find.

It's not a given that I'll get a styloidectomy: if the symptoms aren't particularly bad, which mine aren't, often doctors and inclined to just leave it alone. Although, with calcified ligaments, perhaps leaving it alone would in and of itself be problematic for future surgery.

Any thoughts? Thanks!