I’m not glad that you’re getting symptoms again, but pleased that you feel up to posting for info now…it’s good that your first surgery worked well; if performed by a knowledgeable and skilled doctor intra-oral surgery can be successful, it’s just that external can be better.
You won’t be able to see any blood vessels in the scan without a contrast, so if you’re allergic to the iodine then it’s not possible…you could have an MRI with contrast done, they use gadolinium for that which can have side effects, so I wouldn’t recommend that really wither! You can try to judge if blood vessels are involved by having a look at the sort of symptoms which are common with vascular ES- briefly dizziness, fainting, eye pain with carotid compression, or head and ear pressure, off balance feeling, vertigo, pulsatile tinnitus for jugular vein compression. Here’s a link to the section which has more detail:
ES Information: Common Symptoms And Possible Explanations For Them - Welcome / Newbies Guide to Eagle Syndrome - Living with Eagle
Nerves don’t show on a CT either, there is a special MRI called FIESTA/ Ciss which does show the cranial nerves, but that’s pretty hard to actually get! Again, if you read through the symptoms, you can probably guess which nerves are affected- it’s usually the Trigeminal, Facial, Glossopharyngeal, Spinal Accessory and Vagus nerves which cause problems, for example the voice changes, coughing, feeling something stuck in your throat is usally the Glossopharyngeal nerve…
Looking at your scan, if it was your left side which was operated on before, it looks like it’s quite thick, and has had regrowth after the surgery, so this could well be causing symptoms. It may be an artefact from the scan, but it looks like there’s a small bit of calcification as well, but it looks a bit too central to be the stylohyoid ligament 
On the right your styloid is elongated & sharp like a needle, it looks like there’s a small joint at the end & then more calcification so it could be that the ligament has calcified too.
I would also say that your neck looks pretty straight, it’s lost it’s natural curve, called military neck, we see it quite often on here, it can alter the angle of the styloids sometimes which can make symptoms worse…If you use the search function you can read more about this, some members have done exercises which can ease symptoms a little. It 's a long thread, but there’s some info about exercises and postural changes here:
List of my favourite resources on YouTube to learn anatomy - General - Living with Eagle
We do know of a few doctors in Germany who treat ES, here’s a link in case you didn’t see it when you joined:
Doctor Lists – no discussion - Symptoms and Treatments / Doctor Information - Living with Eagle
looking at your CT and from your symptoms I’d say it’s worth you pursuing a new diagnosis and treatment- if you can get a referral to a doctor on the list that would be great. If you’re having trouble being taken seriously, then we suggest members print off research papers which correlate with your symptoms and take these to your appointment.
I hope that you’re able to get some help, and to enjoy Christmas despite the issues you’re having!
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