@T1423 welcome to the forum. You came to the right place.
Your styloids are very close to C1 and are severely compressing your IJVs (and likely vagus nerves). There’s no contrast in your left IJV, so it’s hard to see. We typically see this when there is severe compression, but sometimes it’s simply due to contrast not circulating in the vein at the specific time of the CT which happens frequently as well.
The average styloid-C1 distance in a healthy individual is about 9mm. You likely have 1mm on your left side, ans a couple mm on your right side.
I would imagine that a bilaterally styloidectomy where the surgeon cuts the styloid above the level of C1 would be helpful. You may also require a C1 shave, as the outer sides of C1 seem to be contributing quite a bit to the compression. Sometimes just styloidectomies are enough though. But you’ll definitely want a surgeon knowledgeable about cutting styloids above C1, to allow the IJVs to open up.
Your biggest hurdle is that your styloids are likely shorter than 3cm. Some surgeons religiously believe that styloids must be longer than 3cm to warrant surgery. However, many of the vascular ES surgeons do not see it that way, and will help regardless of styloid length. So it really depends on the surgeon.
@Isaiah_40_31 and @Jules can likely help you determine who the best specialist is for you to see closest to your area.
I agree with @TML about your styloids & C1 process, that is quite severe IJV compression, I’d just say that on your second image (I’m sorry but I can’t label them), it looks like there’s a piece of calcified ligament which is compressing the IJV against C1, so that would need to be removed.
The doctors we know most about who are experienced with IJV compression & also do C1 shaves are Dr Nakaji in AZ, Dr Hepworth in CO, Dr Costantino in NY & Dr Cognetti in PA, but we have also had a new member from Texas @TexasEagleSuffer who had surgery (C1 shave & styloidectomy) with Dr. Babu Welch at UT Southwestern, 5303 Harry Hines Blvd 7th floor, Dallas, has performed surgery for VES (also Dr Lee Pride, interventional radiologist can diagnose ES) Babu Welch, M.D.: Neurological Surgery | Cerebrovascular Disease | UT Southwestern Medical Center
I hope that you’re able to get a referral to one of the doctors!
You will have to be referred by your ENT or PCP to see either Dr Pride or Welch.
@T1423 - I believe your left IJV is visible in your second image above but is so compressed that part of it is not visible as @TML suggested. What @Jules mentioned might be a ligament pressing against C1 in that image may actually be part of your styloid. It’s hard to tell for sure. Regardless, your IJV is quite squashed.
In the final picture you sent, your styloids appear quite thick & pointed which can allow them to cause symptoms in the absence of being elongated. Your right one is curved which can also cause it to come into contact w/ nerves/vascular tissues a straighter styloid might miss.