A Potentially Catastrophic Anatomical Variation: Aberrant Internal Carotid Artery in the Middle Ear Cavity

Müderris, Togay; Berçin, Sami; Sevil, Ergün; Çeti̇n, Hüseyin; Kırış, Muzaffer

doi:10.1155/2013/743021

Cited by 8 publications

(6 citation statements)

References 14 publications

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“…This imposes diagnostic challenges to the otolaryngologists. 5 But we did not come across any such aberrant course of the vessel. Congenital unilateral absence of the ICA with inter-cavernous anastomosis was also reported earlier.…”

Section: Discussionmentioning

confidence: 78%

“…4 Aberrant course of the petrous part of ICA with bony dehiscence of the carotid canal into the middle ear cavity, resembling a retro-tympanic mass, and as a cause of hearing loss, has also been reported in literature. 5 Awareness of variations in the course and dimensions of the petrous and cavernous parts of the ICA would be useful for radiologists in interpreting the findings on cranial contrast arteriography, MR angiography and duplex ultrasonography. Otolaryngologists and neurosurgeons contemplating head and neck surgeries and skull base surgeries should be aware of the variations affecting these segments of the arteries in order to prevent complications.…”

Section: Introductionmentioning

confidence: 99%

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A cadaveric study of morphology and morphometry of petrous and cavernous parts of the internal carotid artery

Mathew¹,

Lakshmi²

2020

IJCAP

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Internal carotid artery (ICA) is a major source of blood supply to the brain. Awareness of the petrous and cavernous parts of ICA is significant for radiological diagnosis and surgical interventions on skull base. Though several angiographic studies and few endoscopic skull base studies have been done on the artery, there are very few cadaveric dissection studies available in the literature on both the parts. To study the morphology and morphometry of the petrous and cavernous parts of the ICA. The study was conducted on fifty, formalin fixed head and neck specimens in the department of Anatomy, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala, India. The petrous and cavernous parts of the ICA were dissected. The appearance of their curvatures were studied, and any deviations from the normal were noted down. Their length and diameter were measured in cms, and analyzed using mean, standard deviation and ‘t’ test. No abnormal curvatures were noted in the petrous part, but redundant curvature was observed in the cavernous part in 30%, and was more frequent on the right side. Aneurysms were noted in 4% and 10% of the petrous and cavernous parts respectively. The mean length and diameter of the petrous part were 3.8 ± 0.39 cm and 0.49 ± 0.24 cm respectively, and those of the cavernous part were 3.59 ± 0.46cm and 0.48 ± 0.1cm respectively.: Petrous part of ICA is fairly constant in appearance, whereas redundant curvature can affect the cavernous part (30%), and was more frequent on the right side. Aneurysms were less common, but observed in both the parts. There is no significant difference between the length and diameter of both the parts, which measured approximately 3.5 – 4 cm and 0.5 cm respectively.

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Section: Discussionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

A cadaveric study of morphology and morphometry of petrous and cavernous parts of the internal carotid artery

Mathew¹,

Lakshmi²

2020

IJCAP

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“…Vascular pathologies such as glomus tumor, cholesterol granuloma, DMJB, hemangioma, aneurysm of the petrosal segment of the ICA should be considered in the differential diagnosis. [6,8,9] Bilateral aberrant ICA was observed in 2 out of 4 aberrant ICA cases, and 2 cases had an unilateral aberrant ICA on the right TC.…”

Section: Discussionmentioning

confidence: 96%

Non-inflammatory and non-neoplastic soft tissue lesions of the tympanic cavity

Burakgazi¹,

Bayaroğulları²

2020

Anatomy

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Objectives: Tympanic cavity (TC) is an anatomically challenging region for the diagnosis of lesions located inside it. Radiological diagnosis and demonstration of the anatomic localization of sporadic lesions such as vascular malformations and meningocele are essential for the prevention of complications that may occur during operation and recurrent unnecessary interventions. The aim of the present study was to demonstrate the radiological appearance of the vascular variations and the post-traumatic soft tissue lesions which are rarely encountered in TC. Methods: A total of 3525 temporal multi-slice computed tomography (MSCT) images were evaluated between 2010–2018. Twelve cases with non-inflamatory and non-neoplastic soft tissue lesions in TC were detected and 2 with meningocele were included in the study. Results: Of the 12 cases, 6 were males and 6 were females. The mean age of the patients was 26.16 years. Four cases had an aberrant internal carotid artery (ICA), being bilateral in 2 cases and right sided in the remaining 2 cases. Six cases had dehiscent mega jugular bulb (DMJB); and 2 cases had post-traumatic meningocele. Conclusion: Vascular malformations and meningoceles are rarely observed in TC. They may present nonspecific clinical signs and symptoms; however, they should be evaluated with MSCT and MRI before the surgical interventions regarding the middle ear to prevent possible complications.

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“…An epipharyngeal deviation may hinder the procedures within the nasopharynx and lead to the obstruction of nasal airways. At last, an atypical course of the ICAs within the temporal bone can result in nonspecific signs (including hearing loss and tinnitus) or carry a threat of bleeding during the middle ear interventions [31,32]. Many authors have described the hypopharyngeal and oropharyngeal medialization [1,4,7,8,10,21,28,33,44,45,46].…”

Section: The Level Of Arterial Deviationmentioning

confidence: 99%

“…Many authors have described the hypopharyngeal and oropharyngeal medialization [1,4,7,8,10,21,28,33,44,45,46]. Nonetheless, the reports concerning the epipharyngeal and intratemporal aberrations are noticeably rarer [19,22,31,32].…”

Section: The Level Of Arterial Deviationmentioning

confidence: 99%

BILATERAL TORTUOUS INTERNAL CAROTID ARTERIES – a case report, otorhinolaryngologic and general clinical implications

Ziółkowska¹,

Bachvarov²,

Sapundzhiev³

et al. 2017

JofIMAB

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Variations in the anatomical course of the cervical portion of the internal carotid arteries appear to be more common than expected and recognised, reaching a prevalence of 10-43%. A case of atypical course of both internal carotid arteries with medial transposition is described. The general clinical implications are presented in the base of review the literature.In an otherwise healthy adult female pulsating masses on the posterior oropharyngeal wall were observed on transnasal endoscopy for other indications. Contrast enhanced computer tomography revealed bilateral symmetrical tortuous internal carotids, angulated medially at the level of C2 and almost contacting in the midline. However, no significant stenosis was ascertained within any of the evaluated arteries. The patient was informed about potential risk during the prospective surgical procedures around the pharyngeal area. Carotid tortuosity may present a potential threat in otolaryngological surgery. Whereas no symptoms occur in the most of the patients and the condition can be an accidental finding during physical examination as well as endoscopic or radiological evaluation, the frequency in the general population is higher than assumed. The treatment is not indispensable, however, setting down in the patient's medical history is important. Medical specialists should keep in mind that aberrant internal carotid arteries pose a risk of severe haemorrhage when even routine surgical or diagnostic procedures within the head and neck region are performed.

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A Potentially Catastrophic Anatomical Variation: Aberrant Internal Carotid Artery in the Middle Ear Cavity

Cited by 8 publications

References 14 publications

A cadaveric study of morphology and morphometry of petrous and cavernous parts of the internal carotid artery

A cadaveric study of morphology and morphometry of petrous and cavernous parts of the internal carotid artery

Non-inflammatory and non-neoplastic soft tissue lesions of the tympanic cavity

BILATERAL TORTUOUS INTERNAL CAROTID ARTERIES – a case report, otorhinolaryngologic and general clinical implications

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