@JGont - Because you had a CTA, only your carotids are visible in the images you posted. The symptoms you’ve described i.e. ear fullness, tinnitus/pulsatile tinnitus, headaches, rocking feeling & worsening symptoms w/ your head in extension point more to possible internal jugular vein (IJV) compression. I’m sorry the doctor who referred you for the CTA didn’t just suggest a CT w/ contrast as both carotids & jugulars would have been visible then. In order to see your jugulars, you’ll need to get a CTV of your head & neck, & if you can get it done dynamically i.e. w/ your head turned L/R & looking up/down, that will provide better evidence for/against IJV compression.
You’re correct your styloids aren’t long but the right one is quite thick. The way it appears to be slightly pressing on your internal carotid artery (ICA) suggests that it may be causing compression of your IJV & potentially your vagus nerve as the IJV & vagus both exit the skull very close together. The vagus compression would help account for your increased anxiety level & the IJV compression, the other symptoms I mentioned. I’ve annotated an image of your right side to help you understand what I see. The segment of calcification on the left that’s separate from your styloid is calcification of your stylohyoid ligament just below your styloid.
If you can upload a picture of your axial image (4th picture) closer to C1, I can point out your styloid & IJV there. I think I can see those on the present image but am not certain enough to annotate them. Here’s a tutorial that @TML gave us about how to ID important structures at the level of C1.
One other thing of note is that you’ve lost your lordotic cervical curve. When the natural curve of the cervical spine is gone, the styloids & greater horns of the hyoid bone naturally move closer to the nerves & vascular tissues in the neck. It’s possible to restore the proper curve, but it takes time & patients. Some PTs are educated to help with this and we also have an excellent discussion thread that is helpful, too. List of my favourite resources on YouTube to learn anatomy
