Sounds like a good plan. 
Thanks to TML, I have some images to share. And he gave me some info. My left styloid is much more prominent than my right. My right seems to be within normal limits for length, at around 2.8 cm, while my left is much longer at around 3.5 cm.
Both of my internal jugular veins make contact with my C1 transverse process, but neither of the IJV are being compressed or even touched by my styloids, so that’s good. It’s possible that the degree of compression happening at C1 is causing some of my symptoms. These would be intracranial hypertension symptoms like headache, eye/ear pressure, dizziness and balance issues, cognitive changes, neck, should and back pain. Also nerve-irritation symptoms on the left side from the elongated styloid, such as facial nerve irritation, left side of inner mouth sensations, left ear fullness (similar to eustachian tube dysfunction), etc.
The CTA head/neck radiologist’s report failed to discuss the styloid, even though they agreed to look at that for me. In fact, all the results said were, “There is no evidence of hemodynamically significant stenosis involving the visualized arteriovascular structures of the neck. There is no evidence of dissection or branch vessel occlusion. The soft tissue structures and osseous structures are unremarkable.” I don’t sense the radiologist addressed everything that is visualized. What do you all think?
Now that we know this information from TML’s help, I have questions for everyone. Are there any suggestions for what I should avoid to reduce the triggers for symptoms? (Example: maybe rotating my head?) Another question I have is are there any non-surgical precautions or treatments? (I haven’t ruled surgery out, but I’m a poor surgical candidate, so I’m trying to learn to live with it.) Is there value in watching to see if these are still growing, by doing another scan in a couple of years? Or even sharing an old scan to see if there has been ongoing growth? I have one from 2013 that mentioned a calcified left stylohyoid ligament, but did not measure length or call it elongated, but it did suggest Eagle Syndrome as a possible diagnosis. Then this was confirmed by two doctors, but neither recommended surgery. If anyone has any feedback from these images or my story, I would be most grateful! (Again, thanks to TML!) And is there anything going on that points to surgery as the only way to find relief or prevent something dangerous from happening?
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@WillisWay - Your 3D images are wonderful! Thx, @TML for helping her with these.
What I feel is far more significant than C1 possibly compressing your IJVs is that your styloids are resting or possibly pressing against your internal carotid artery on the right & external carotid artery on the left. That the styloids have contact w/ your carotids on both sides, & the fact that head turning can cause the styloids to put more pressure into them causing irritation & even temporary compression, puts you at risk for TIAs (transient ischemic attacks i.e mini strokes) or worse. The vascular symptoms you have are more likely coming from your styloids contacting your carotids than from the possible IJV compression.
The situation as I see it means that having bilateral styloidectomies should be a more serious consideration for you than waiting & trying to cope w/ your symptoms. The only non-surgical treatment that might be helpful is to start taking a blood thinner, and you’d need to get an Rx from a doctor for that. I know surgery isn’t ideal for you, but I believe your situation calls for it.
This sentence was likely in your report because your styloids aren’t affecting your carotids when your head is in a neutral position, however, with head turning left or right, they are making more significant contact w/ them, & your symptoms seem to indicate the carotids irritated.
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@Isaiah_40_31 thanks for catching the carotids!
I relabeled your axial imaging to include the carotids. Your ECAs are in contact with your styloid tips, which seems to be a common theme when I’m looking at ES imaging lately. This can contribute to ear symptoms - potentially pulsating tinnitus, ear fullness, dizziness. Your ICAs seem to be a good distance away, so much so that I think it would be difficult for you to move your head in a way that one of your styloids would sever them. But yeah, your IJVs, probably vagus nerves, and your ECAs are compressed in this specific imaging where you’re laying on your back. I agree with @Isaiah_40_31 that if you can get surgery and get both styloids removed that would be good.
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@TML - We make a good team! 
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Thank you so much for this added information. I confess being overwhelmed for many reasons. I’ve had Long COVID for 14 months and am in speech/neuro rehab for that twice a week. I am dealing with Sciatica and have had two prior surgeries for that and am told I’m not a good candidate for another surgery for that. I have primary immune deficiency and my twice weekly SCIG isn’t going well. I have several autoimmune diseases. My husband has Stage 3C cancer. It’s just a lot right now! And I don’t really have a support system in place to help me get to appointments. Right now, I’m only being seen by my PCP because I’m just tired of so many doctors missing so many of my issues (including the ones who missed my own cancer and many years of the immune deficiency). I keep getting gaslit by doctors, when I think often it’s because my case is too complex for them and they don’t want to admit it. My PCP is a great support. It’s also scary to deal with this because my father had a Carotid Endarterectomy and his tissue was friable so, despite a 12-hour surgery they couldn’t stitch him up and he died a week later from a vegetative state. I normally don’t have a lot of fear, and I’ve had over 20 surgeries, so I think I’m fairly stoic. I’m just admitting all the factors. I guess my next three questions would be. 1) Do you have recommendations for how I should word my concerns to my PCP regarding Eagle Syndrome (styloid), Carotids, and Jugulars (considering the head and neck CT/CTA did not discuss these issues)? I will see him in 3 weeks, so this is a good time to think through this. 2) Since transportation is hard for me, are there any experts I could send my symptoms and test results to and have a tele-visit? 3) Another possible diagnosis that could complicate things is Ehlers-Danlos. Do you think I should be tested for that so that we know all the facts so if I do have surgery there are no surprises?
Thanks again!
Kathy
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This is so helpful! Thank you!
Kathy
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Oh my goodness @WillisWay , I’m so sorry to hear about all your difficulties. I really can’t even imagine how difficult things must be. Making big decisions on top of all that must be daunting to say the least.
Something to think about - vagus nerve plays a big role in autoimmune and inflammation. If your vagus is compressed and is not properly regulating the parasympathetic nervous system, autoimmune disease can more easily run rampant. I believe Dr. Hauser published a paper or said in a video that vagus and carotid sheath difficulties can actually result in or mimic autoimmune disease. For example, if your styloids impact the nerves important in salivation, one could be misdiagnosed with sjogens.
Basically what I’m trying to say is that elongated styloids can result in a domino effect of health difficulties. It could be like the example I stated above. Who knows, elongated styloids could result in compensation posture of the head and neck in turn throwing off the pelvis and resulting in sciatica. Not saying that’s what’s causing your sciatica obviously, but it’s crazy what the body will do to compensate under chronic (sometimes subconscious or undetected) stress.
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Excellent information, @TML. The whole posture being off due to the styloids scenario could explain why the sciatica surgeries haven’t helped. The info about the vagus causing a possible pseudo autoimmune response is also very interesting. I think I’ve heard that before but had totally forgotten about it.
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And to back it up, here’s a review showing that vagus nerve stimulation as treatment can be an effective adjunct therapy for a wide range of autoimmune disease!
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The problem is with ES, you can stimulate the vagus nerve all you want but since it’s compressed the stimulation doesn’t transmit as it should. So decompression would be necessary. However, I’m thinking that if only one vagus nerve is compressed you could stimulate the other one and I wonder if it would carry some slack of the other? Would be interesting study for sure.
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@TML - the left side of the vagus is dominant so I’d expect if your theory worked it would do best if it was the left branch of the vagus that was liberated.
Interesting article, too. I didn’t read the whole thing but enough of it to get the gist of the study & results. Thx for sharing the link.
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Both of you bring up very good information. I know I for sure have several autoimmune diseases due to biopsies and lab work. (Example: Sjogren’s was confirmed by salivary gland biopsy, Hashimoto’s was confirmed by pathology from thyroidectomy w/ cancer as well.) The low back issues ended up with “failed surgery” due to adhesions growing inside the spinal canal. I also have a tethered cord. But thankfully I had had about 10 or 15 years of relief before it returned about two months ago. And we do think part of the issue is mechanical and posture. I’m going to a therapist who uses McKenzie Method to try to help with it. But you mentioned vagus issues. I have several tie-ins with vagus issues, including POTS and that fright/flight sensation that lasts longer than it should and often for no good reason. Many of my issues started or were made worse since COVID. One of the issues that led Mayo to do my CT in 2013 was the fact that I feel like I’m swallowing glass when I try to sing. They did catch the ES but it was on my last day there and they sent me home with Tylenol (no joke) and said I could go to my regular ENT for discussion about ES. The ENT in Austin, TX (and a second opinion also in Austin, TX) both did not recommend surgery. But they did not look at the actual images–just read the Mayo report. I think a lot gets dropped through the cracks. I definitely see what you mean about how one thing (such as styloids) could have a domino effect on other issues. I had an early generation spinal cord stimulator for over 10 years. The leads are cemented to my spine, but they’ve removed half of the cable as well as the battery pack. I had a severe post-surgical infection after they removed the battery that required a long hospitalization and follow-up. There’s a lot to factor in! I’ve been listening to the 3-hour webinar that you all recommended a couple of weeks ago. It has given me a lot to consider, as well.
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Interesting thought, but maybe the compression could be irritating the vagus so as to cause over stimulation? Massaging it causes some stimulation & is supposed to be calming , but over stimulation seems to produce the symptoms members often have… Idk if stimulating the opposite side could be even worse?
Vagus Nerve Overstimulation: Causes, Symptoms, and Solutions
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I’m so sorry too that you have so much going on health-wise for yourself, and then to be looking after your husband too is very hard for you 
There do seem to be quite a few members who have AI diseases alongside ES, so maybe the chronic inflammation ES causes triggers an OTT immune response, just an idea, not that iy solves anything! I have very dry mouth & eyes, my blood tests were negative for Sjogrens & as they’re bearable & I wouldn’t have wanted to take medication anyway I didn’t ever pursue the lip biopsy…
It does sound as if surgery would be really hard for you to manage right now…it’s a tricky one as there are risks to leaving the styloids in, but doesn’t sound like you have much choice! Some members have found that blood thinner meds like plavix, brilinta or xarelto can help with the symptoms of IJV compression, but I’m not sure whether that would help with the ECA compression symptoms…
There have been discussions on here about how correcting posture can sometimes help with ES symptoms, although obviously not a cure, whether there’s much you can do given your other spinal problems I don’t know, but if you have time you could have a look? Here’s a link:
List of my favourite resources on YouTube to learn anatomy - General - Living with Eagle
Sending you hugs and prayer 
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I completely agree with you @WillisWay! Too many doctors rely on what another doctor/radiologist has said rather than looking at scans for themselves & drawing their own conclusions independent of other’s opinions. I’m very sorry that happened to you early on. I suppose the good that could come from this is that ES surgerical techniques seem to have improved over the last 12 years with post op pain being reduced, & in some cases, healing time, too.
I think taking a blood thinner for carotid compression is also beneficial because it reduces the risk a blood clot forming & causing other severe problems. That would be a discussion you could have with your doctor.
Your situation with so varied health challenges & spinal conditions, does make getting surgery a less straight forward decision for you, plus lack of support at home post op. I wish this whole situation was less messy for you. I’ll pray you’ll be able to have the surgery at some point so you can at least recover from the symptoms your styloids are causing.
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