@Sunshine - Welcome to our forum. I’ve annotated the two pictures you posted.
I’m sorry you’ve had such bad symptoms for so long but I’m glad you were finally diagnosed. Your left styloid is normal length, but you have sections of calcified stylohyoid ligament down the length of the whole ligament to your hyoid bone. On the right, I’m not sure what I labeled is your styloid, but if it is, it looks very short & thick. You also have at least one section of calcified stylohyoid ligament on the right. I couldn’t see all the way to your hyoid on that side because your mandible is in the way.
The more interesting thing I noticed is the transverse processes of your C1 vertebra are quite large & the left side almost looks like it could be a form of ponticulus posticus/arcuate foramen, but I could also be wrong about that. Due to how big the TPs of C1 are, & how close they look to your internal carotid arteries (ICAs), I suspect you may have internal jugular vein (IJVs) compression. Unfortunately it looks like you had a CTA so the IJVs are not visible only the ICAs are. IJV &/or ICA compression can cause positional dizziness & tinnitus, however, your ICAs look fine in the pictures you posted so I’m suspicious your problem may lie with your IJVs.
The reason IJV compression can cause dizziness/vertigo is because deoxygenated blood & other toxins flow out of the brain through the IJVs & freshly oxygenated blood flows into the brain through the ICAs. When the IJVs are compressed, often at the level of C1, blood can’t flow out of the brain as fast as it’s flowing in so a situation of high pressure (intracranial hypertension) occurs in the brain which can cause dizziness, tinnitus/pulsatile tinnitus, brain fog, visual changes, a sense of derealization, & migraine headaches. Sleeping with head/shoulder elevation at night can help reduce the pressure temporarily. Icing your neck for 15 min several times/day, w/ a thin cloth between skin & ice pack to prevent ice burns, can help w/ the nerve pain symptoms.
If you can get a CTV (contrast is injected at the venous phase of the heartbeat) so the jugulars are visible, that would help to be able to rule IJV compression in or out as a possible cause of some of your symptoms.
The other symptoms you’ve mentioned are common w/ ES & are caused by irritated cranial nerves which can become irritated by elongated styloids &/or calcified stylohyoid ligaments.
I agree that your cervical spine is quite straight but that can be corrected gradually using gentle PT exercises. Here’s a link to a discussion thread where there is information about how to do that: List of my favourite resources on YouTube to learn anatomy
Many of our members who’ve had vascular decompression surgeries & styloidectomies have had good reduction or resolution of dizziness & the other symptoms you’ve listed.
