Hi & welcome to the site!
As @TML says, the angle can make a difference with what symptoms are or aren’t caused, & the thickness of the styloid too. & you’re right that often people do get symptoms from the opposite side after surgery for their symptomatic side- whether it’s because there’s a shift in the neck when one styloid is gone, or whether one was masking the other we don’t know, & we have had a couple of people with cross-over symptoms, where the symptoms where felt on the opposite side!
For many doctors it isn’t a complex surgery, but there are lots of cranial nerves & important blood vessels in the area- the facial nerve particularly is very delicate and easily damaged, so this puts many doctors off doing the procedure. Also if a doctor isn’t confident enough (or not that knowledgeable) to shorten the styloid as high as it’s safe to do, then the surgery might not help. We’ve had quite a few members whose styloids were shortened a bit but not enough so they still had symptoms.
So firstly it’s worth considering the risks of surgery (as with any surgery there’s risks of bleeding, or stroke, & with ES surgery there’s risks of nerve damage to the facial nerve which can cause facial paralysis, or the spinal accessory nerve which can cause shoulder or arm pain/ weakness.), and weighing that up against the symptoms you have and what effect on your quality of life they’re having. There isn’t really any definite way to tell for sure about whether the surgery will work, but the nerve block if you have one can sometimes give you an idea…
Then secondly, in choosing the right doctor there’s questions we suggest you ask in the Newbies Guide Info section about surgery. Dr Samji has done lots of successful surgeries for members with ‘classic’ ES like it sounds as if you could have, if members have vascular ES symptoms we suggest they see one of the doctors more familiar with that. Do you know how many of these surgeries Dr Merati has done?
Here’s a link to the surgery info:
ES Information- Treatment: Surgery - Welcome / Newbies Guide to Eagle Syndrome - Living with Eagle