Your styloids are a little longer than average, but they’re quite angled which can cause symptoms as well…the Vagus nerve if irritated can cause cardiac arrhythmia, and if the styloids irritate the carotid sinus this can cause cardiac issues too. I’m not knowledgeable enough with the scans to comment on the blood vessels your styloids are close too, but on the last image it looks as if there could well be irritation if not compression by the styloid process. There looks like calcification (on the left side of the first image) of the stylo-hyoid ligament, unless the styloid has been fractured at some point. Your hyoid bone processes also look quite long and as if they could be touching blood vessels too- this is only an amateur opinion, just a few pointers for you to discuss with your doctors!
Some of your symptoms sound like common ES ones, but some less so (the weakness in your legs, pinching of your spinal cord etc could be more to do with your other neck problems). Here’s a link to the info about common symptoms & also Vascular ES:
ES Information: Common Symptoms And Possible Explanations For Them - Welcome / Newbies Guide to Eagle Syndrome - Living with Eagle
We do also have some info about surgery & in this section there’s a list of questions as a guide to ask your doctor:
ES Information- Treatment: Surgery - Welcome / Newbies Guide to Eagle Syndrome - Living with Eagle
It’s good that you have found a doctor who knows about ES and is willing to help you, if you choose to go ahead with surgery. Unfortunately it’s not possible to say which symptoms are being caused by your styloids & which aren’t- the only way really to tell is to have the surgery and see what resolves, but equally there are risks with surgery so it shouldn’t be undertaken without thinking it through. I wish we could give you a clear cut answer, but it’s a personal decision based on your quality of life with the symptoms you have…
I do strongly suggest though that you are cautious about seeing a physiotherapist/ chiropractor if they’re not knowledgeable about ES, given the length & position of your styloids it could damage a blood vessel or cause more irritation to your vagus nerve if that’s being affected.
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