Thanks for the support @Isaiah_40_31 @Jules.
Just got back from Phoenix last night. Both Dr. Costantino and Dr. Nakaji have accepted me for surgery and I decided to go with Dr. Nakaji despite having to wait longer for the surgery, August 19 versus July 1. Mainly, Dr. Nakaji has been working in this area since 2004 and is part of the group of doctors who are really trying to understand venous congestion and develop best practices for diagnostics and treatments. For me personally I prefer that, other than resecting the styloid and C1, the rest of the surgical plan will be determined in the field based on what he sees. He said he has done a lot of work with 3-D modeling and found that the styloids do not have to be resected to the skull base. In most cases some styloid can be left with IJV still freed up and this helps prevent damage to the facial nerves. I asked about styloids growing back since I have seen that pop up on the forum and he said he has not seen that himself but can see how it could happen if the ligament isn’t properly removed.
He is very selective of surgical candidates (as are the other surgeons I consulted) and if anyone is considering him as a surgeon you for sure have to have an IR angiogram with manometry to get a consultation. I consulted with 4 surgeons (Samji, Osbourne, Costantino and Nakaji). the other 3 said they would start with the right because it is the dominant side. Dr. Nakaji thinks we should do they left because it is much worse and if we can open that up combined with some flow I already have on the right it might be enough to relieve the symptoms. I have always felt the same way so that was another reason I decided to go with him. Fingers crossed to be able to get in earlier than August 19!