Styloidectomy for Jugular Decompression in Venous Outflow Disorders.

Area of Science:

• Neurosurgery
• Vascular Surgery
• Neurology

Background:

• Jugular venous stenosis at C1/styloid process linked to cerebral venous outflow disorders.
• Symptoms include headache, pulsatile tinnitus, and cognitive issues.
• Limited data exists on open decompression via styloidectomy outcomes.

Purpose of the Study:

• Evaluate the effectiveness and complications of styloidectomy for symptomatic jugular venous stenosis.
• Clarify outcomes in a larger patient series.

Main Methods:

• Retrospective review of 41 patients undergoing styloidectomy (with/without C1 resection) for symptomatic jugular stenosis (2022-2024).
• Inclusion criteria: refractory symptoms, confirmed IJV compression, dynamic venographic evidence of elevated jugular gradients.
• Assessed baseline characteristics, perioperative data, and short/long-term outcomes.

Main Results:

• 70.7% of patients reported symptomatic improvement post-surgery.
• Mean reduction in Cerebral Venous Disorders Severity Scores was 1.83.
• Common temporary complications (56.1%) included shoulder pain, numbness, swallowing difficulty; 4.9% had marginal mandibular nerve palsies. Over a third required additional interventions.

Conclusions:

• Styloidectomy is effective for selected symptomatic internal jugular vein compression patients, providing meaningful relief.
• Complications are common, necessitating further interventions in many cases.
• Critical evaluation and patient selection are vital for managing cerebral venous disorders with open decompression.