@1speechpick I am not sure what the CT without contrast can tell that CT Angio with contrast can’t tell. I think it would be very difficulty to see any vascular issues with CT without contrast as the vessels need contrast to be fully seen. I think your Styloids are not elongated but they do not have to be long to cause vascular/nerve compression. All it takes is the wrong orientation & angle to cause problems. For example, My left styloid is 1.8 cm and is compressing my dominant jugular vein. So I would not seek another CT just obtain measurement as I believe the sizing can be obtained with the current contrast CT. You just need to play with 3D imaging tool to get to the Styloid and measure it. There is good tutorial in this site on free 3D Slicer software ( Making Your Own 3D Images from CT Scan- 3D Slicer Tutorial ). This brief tutorial contains on how to get to the Styloid on different position, you can then measure it with the 3D tool. In order to see the Styloid, you need to remove the frontal mandible bones so you could see whether it is contact with your vessels as well.
As far as Axial images are concerned, The CT Scan Series are labelled with Axial, Sagittal and Coronal. So you can view them with any DICOM viewer such as 3D slicer but you need to know how to get to the styloid and Carotid which might need a little learning on anatomy & how to read CT Scans.
So coming to the frontal view image you provided, the Hyoid bone is indeed between Carotid bifurcation, I can see that clearly that your left Hyoid Greater Cornu is in between the 2 branches of the Carotid artery and is in close proximity to the Interior one (possible touching it which can cause a whole host of symptoms) This needs to be investigated with Dynamic CT angiography at the neck level in order rule out if this is coming into contact with your Carotid Artery when you move your neck or swallow food as swallowing causes the Hyoid bone to move up. This could potentially mess with your Hypoglossal nerve causing tongue issues as well. This is condition (Carotid artery entrapment by the hyoid bone) is linked to stroke as well so the earlier you attend to it the better.
The cyan circle and arrow show where Left Hyoid Cornu might be messing with your Carotid.
The following images are from the study and see how similar your images on the Hyoid bone look to this one. There is also video animation in the study link which you can download and watch how the right horn of the hyoid bone is in between the two branches of the carotid (ICA & ECA)
Here is Study Link : Carotid artery entrapment by the hyoid bone
Here is link to video : Video from the study above to show you how the Hyoid is in between the Carotid branches