@Winmag - Welcome to our forum. I’m very sorry to hear how your wife is suffering but am happy for you that she saw Dr. Heim, and he is willing to do surgery to shorten her styloid/remove the calcified stylohyoid ligament. We’ve had quite a number of German members who’ve wanted to see him & have him do their surgeries but were told he is no longer doing ES surgeries so your news is welcome as it sounds like he is doing them again.
Can you add a picture like the last one you posted except of the right side showing the 3D sagittal image w/ the styloid. It would help me better understand what her right side looks like. I can see the left styloid is very small and there is a little calcification of the stylohyoid ligament there, too.
Your wife’s symptoms are all among those that have been noted on our forum as being caused by ES, & in most cases, the symptoms are reduced or completely go away over some months after surgery to remove the styloid. Dr. Heim has a very good reputation for producing good results when he does ES surgeries so your wife should benefit greatly from the surgery he does for her.
Surgical recovery can take time and is not linear i.e. symptoms will come & go over the 2-12 months it can take for the irritated nerves to heal completely. Your wife will likely be tired for a month or two after her surgery, but her full energy will gradually return. I think our bodies slow down during recovery to force us to be less active so the energy can be put into healing.
Here are links to two posts that will be helpful for you to better understand the causes of ES symptoms & why surgery is the best option for recovery from ES symptoms: