Thank you for the information 
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@Calista21269, Can you tell me which image you see IJV compression in? I canāt really see the IJV well enough in your recent images to determine if there is compression. Also, I canāt advise one way or the other about whether you should try to have HBS surgery. If the doctor(s) you consult think itās a good idea then that is the opinion you should follow. You may need to have both your styloids & greater hyoid horns shortened. I know thatās something Dr. Chhetri can do. Iām not sure about the new doctors whose names weāve just gotten though. Dr. Dewan only does hyoid bone surgeries so itās probably good her office never got back to you.
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Here its not like the right side ?
Do you think I should have HBS and ES surgery?
Iām lost at the moment; I donāt know whether to have HBS surgery or PICL first because I also have CCIā¦ and regarding surgery for eagles, itās said to worsen CCI.. , HBS too I think, but a little less than for eagles surgery
Dr. Chhetri told me to get the injections first.But to perform these injections, you need an ENT specialist in HBS, and one whoās willing to believe me; in France, thatās not the case.. And the injections are also bad for the CCI and ligaments 
Right, I can see what you mean about the IJV compression in that image, it looks like C1 is involved too. Unfortunately thereās no easy way to tell which surgery will help the most, sometimes we have to try & get a few opinions & then see which doctor you feel most confident with, but obviously thatās even harder for you with not being able to see them ā¦ There is no consensus about whether C1 shaves & styloidectomies make CCI worse- some doctors think it does & others disagree, and members have had different experiences too! Same with the PICL treatments, some believe it was helpful, others feel it was an expensive waste of moneyā¦I wish we had the answers for you, but unfortunately nobody knows for sure what will help & what wonātā¦praying that you are able to find the right doctor 
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@Calista21269 - I donāt remember seeing that image posted above or before. Iām sorry if I missed it. It does look like you have significant compression of your left IJV being caused by your C1 vertebra. As @Jules said, there are mixed opinions both about whether nor not ES surgery w/ C1 shaving causes CCI to worsen & whether or not alternative therapies for CCI really help or not. I think itās very individual i.e. some people have no worsening of CCI post styloidectomy/C1 shave while others do. Some people respond well to PICL or steroid injections where others do not. I think when peopleās symptoms get bad enough, many are willing to take the risk of having surgery or, if they can afford it, to try the alternative therapies in hopes that something will help.
The general consensus on our forum is to start at the top & work down i.e. have a styloidectomy & IJV decompression surgery, give yourself 6 months of recovery time, & see what symptoms you still have then proceed from there. If you still have hyoid symptoms then pursue HBS surgery.
Iām so sorry youāre in such a tough position & without good medical help or guidance. I wish I had a solid answer for you. I will also pray for you that you know what the best decision as for moving forward. 
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Thank you for your help
Actually, I thought I had uploaded the image, but it didnāt load, so please donāt apologize. We can see other images here
(Left and right side in this images you can see better maybe, the jugular on right side looks like bigger than left)
Iāve had tinnitus since 2022 following COVID, Itās true that I have a bit more of it on the left, so maybe itās because of the jugular vein? And sometimes when I turn my head I get dizzy, but that could also be because of the hyoid bone or CCI , I donāt knowā¦
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Thank you for your help , I need to think carefully about what to do and whatās causing my symptoms.
Right now, I have the impression itās mainly related to my hyoid bone, and I hope Iām not mistaken..
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In this image it looks like there could be another smaller blood vessel which could be contributing to some compression too?
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Do you think I have a slight compression on the right side as well?
The reason your right IJV is bigger than your left is because itās your dominant IJV. Many people have a dominant & non-dominant IJV, however in some people, theyāre pretty evenly sized.
I see the small vessel youāre talking about, but I donāt think itās causing any problems. Your right IJV looks healthy & compression-free to me.
With the amount of compression your left IJV is suffering, I suspect some of your symptoms are coming from that source.
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Thank you for you answer .
What symptoms besides tinnitus and vertigo / dizziness does jugular compression cause?
IJV compression can also cause brain fog (not thinking clearly), visual changes like visual snow & visual distortion, derealization i.e. inaccurate depth perception, feeling drunk when youāre notā¦Those are the main ones.
Okay, thank you. So, based on these images, my left jugular vein seems slightly compressed by C1? If I address the issue with CCI , perhaps that will resolve this problem as well ?
Also, many people have a compressed jugular vein without necessarily experiencing any symptoms ? I think Dr. Centeno mentioned this in one of his videos
Your left IJV looks significantly compressed to me, but if your right side is sufficiently draining the blood out of your brain, you may not be terribly symptomatic from the compression of the left IJV. Addressing CCI might help reduce the compression of the left IJV, but I donāt know what kinds of therapy youāre considering that could help with that.
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Okay thank you .. I would first like to resolve the throat problem (either Eagles or HBS), then maybe consider a PICL and physiotherapy to restore the curvature
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