When jugular vein compression is eased by having the styloid removed, pulsatile tinnitus does often resolve, but there’s no guarantee … It does sound as if you have quite a few other symptoms as well, personally for me I was able to control the nerve pain enough to live with it, but the vascular symptoms were too bad to live with- I had constant off balance feeling, dizziness, head and ear pressure, brain fog, and some other weird, scary feelings like I was falling, and sucking/ rolling feelings inside my head. Sometimes these symptoms can get worse; the body diverts blood through other veins (collateral veins), which swell and take some of the load, but many of us get to the point where they stop compensating and the symptoms worsen.
I’m not encouraging you to have a surgery if you’re not sure, but it’s worth considering that these symptoms are unlikely to get better and may worsen, and there can also be cognitive effects, there have been a couple of research papers posted recently which are worth considering:
AGHAYEV (2026) - Review: Jugular Vein Compresion and Dementia - Emerging Evidence - General / Research Papers - Living with Eagle
Peng et. al.–Surgical treatment for cognitive impairment caused by IJV stenosis: clinical study of C1 transverse process resection - General / Research Papers - Living with Eagle
I don’t know if this is helpful, but some members have mentioned this doctor, as he has a pulsatile tinnitus clinic at UCSF, although as yours is likely caused by styloid compression there might not be anything non-invasive which would help… :
Matthew Amans, MD, MS - Neuroradiology, Diagnostic Radiology | UCSF Health