I just had my cerebral angiogram, and it showed a pressure difference across one of my styloids. This helps me to know that not only is it compressed, but could be contributing to the veinous outflow problem that I have. The other side is also compressed, but didn't show a pressure gradient, so that one probably doesn't need to be removed. It helps me because you know that a garden hose can be pinched a little, and you can still get a lot of water through there. However, there is a point where it's too pinched off, and you can't get enough water through to water your plants. There is a point at which it becomes a problem and I think measuring the gradient helps in making a decision about whether to take the styloid out.
I think he's just really saying that there isn't evidence for the eustachian tube dysfunction being from Eagle's, but remember, there isn't a whole heck of a lot OUT there about Eagle's to BEGIN with... and there is even less about the vascular version.
I know that blood backing up in my head is swelling things up- I can make this happen, and feel tissue in my face and nose swell up. I think the tissue forming the eustachian tube also swells at least a little bit, and closes the area. However, I think the main cause of the eustachian issue is the neck muscles-- I am actually a little bit improved on the eustachian problem, now. It used to be ALL the time. Now it is NOT all the time. When I do pushups and kettlebell swings, the eustachian issue is worse. That says a lot.
I think neck issues and Eagle Syndrome have a connection, with one making the other's symptoms worse. Either neck issues exacerbate Eagle's symptoms, or those styloids kick off a neck muscle reaction (or the pain from the styloids-for those with pain-cause them to hold their neck muscles in contraction or very still, shortening them over time).
The angio was no big deal; I had it yesterday. It was painful when the dye was squirted, but that's it. The biggest pain is laying flat for 4 hours afterward in the hospital bed, so that your femoral doesn't open back up and pump blood out.
I'm overall feeling pretty great since I have figured out the neck muscle connection; I was having one of my best days among a couple of great weeks when I did the angio. I would have liked to see what it showed when I had my worst days.
I would consider that it's entirely possible that your eustachians are connected to Eagle's. He certainly isn't saying NO. He can only go with what was published and what he has seen. BUT...from my own experience, I'd seriously consider the neck, ESPECIALLY if you were weight training in the gym, trained with something like a crossfit workout, or know you have horrible neck posture with work or leisure activities that you spend a lot of time doing.
(I realize you already know a lot of this; I'm typing also because there are a lot of new people here and I noticed some neck questions earlier, so I repeated a lot of what I said in some of my more recent posts)
I have been feeling pretty normal and not fatigued or screwed up in the similar ways that we are both symptomatic-- MORE often that not, I feel pretty good! It was recently NOT this way, remember, so there IS hope sans surgery! I may need surgery to get all the way back, but I'll take what I've got so far!