Beware bleeding from the ear

John, David Gareth; Porter, M. J.; Hasselt, C. Andrew van; Med, M.

doi:10.1017/s002221510012242x

Cited by 30 publications

(23 citation statements)

References 4 publications

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“…4,9,10,14 Some investigators have documented the complication of radiation-induced aneurysms with subsequent rupture. [1][2][3][5][6][7][8][11][12][13] We present a patient who suffered SAH due to an AICA pseudoaneurysm that was probably induced by GKS for a vestibular schwannoma.…”

mentioning

confidence: 99%

Ruptured pseudoaneurysm following Gamma Knife surgery for a vestibular schwannoma

Akamatsu¹,

Sugawara²,

Mikawa³

et al. 2009

JNS

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A 75-year-old woman underwent Gamma Knife surgery (GKS) for a vestibular schwannoma. Eight years after GKS, she suffered sudden onset of headache. Computed tomography revealed diffuse subarachnoid hemorrhage around the cisterns of the posterior fossa. Right vertebral artery angiography showed an aneurysm arising from the lateral pontomedullary segment of the left anterior inferior cerebellar artery. The aneurysm was not located at a branching site. Trapping of the distal anterior inferior cerebellar artery aneurysm was performed, and the aneurysm was removed. The pathological features of this aneurysm are discussed. This aneurysm was diagnosed as a pseudoaneurysm pathologically. This is the first report of aneurysm formation with pathological findings following GKS for a vestibular schwannoma.

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mentioning

confidence: 99%

Ruptured pseudoaneurysm following Gamma Knife surgery for a vestibular schwannoma

Akamatsu¹,

Sugawara²,

Mikawa³

et al. 2009

JNS

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“…The coils can extrude into the nasal cavity or auditory canal with the risk of infection. 27,28 To decrease exposure to foreign materials, stents alone were used to exclude the aneurysm from the circulation. Our initial experience with coronary stents was satisfactory, thus we continued the reconstruction of ICAs with covered stents when they became available.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of ruptured internal carotid artery pseudoaneurysms after irradiation for nasopharyngeal carcinoma patients

Mak¹,

Cheng²,

Cheung³

et al. 2013

Hong Kong Med J

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229Objectives To evaluate the efficacy and complications of endovascular treatment for ruptured internal carotid artery pseudoaneurysms following irradiation of nasopharyngeal carcinoma.Design Retrospective case series.Setting Tertiary neurosurgical referral unit of a Hong Kong public hospital.Patients Patients with ruptured radiation-induced internal carotid artery pseudoaneurysms that were treated endovascularly from October 1999 to October 2011 at Queen Elizabeth Hospital were reviewed. Hospital records, imaging, and angiographic data were studied.Results During the study period, 15 such nasopharyngeal carcinoma patients were treated by endovascular means at Queen Elizabeth Hospital. Ten presented with epistaxis, three with otorrhagia (bleeding from the ear), and two with both. Therapeutic occlusion of the affected internal carotid artery was performed in four patients, and stenting of the artery (with or without coil obliteration of the pseudoaneurysm) was performed in 11. Immediate haemostasis was achieved in all cases. One (7%) of the 15 patients endured symptomatic recurrence of the pseudoaneurysm, and in another an asymptomatic residual pseudoaneurysm was noted in the follow-up angiogram. Three patients suffered clinically significant procedure-related complications, including cerebral infarction (n=2) and brain abscess (n=1). In the angiograms obtained after a mean posttreatment interval of 13 (range, 0.7-60) months, the stent patency rate was 67%. All three patients with occluded stents were asymptomatic.Conclusions Ruptured internal carotid artery pseudoaneurysms following radiotherapy is a rare but life-threatening condition. Endovascular treatment by occlusion or reconstruction of the internal carotid artery with stents provides immediate haemostasis and obliteration of the pseudoaneurysms, with a low recurrence rate. Long-term follow-up is necessary to look out for delayed posttreatment complications.

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“…The incidence of temporal bone osteoradionecrosis is also higher when amastoidectomy or temporal bone resection is done for surgical clearance, followed by post-operative radiotherapy [6]. Diffuse type is associated with various complications such as suppurative labyrinthitis, meningitis, cerebrospinal fluid leakage, and internal carotid aneurysms [7].…”

Section: Discussionmentioning

confidence: 99%

Diffuse Osteoradionecrosis of Temporal Bone as a Late Complication of Adjuvant Radiotherapy to Parotid Bed: A Case Report

Ganesan

et al. 2014

JCDR

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Localized osteoradionecrosis of bony external auditory canal has been described as a late complication of external beam radiotherapy which is delivered to parotid bed after surgical resection of parotid malignancies. Diffuse osteoradionecrosis of temporal bone is rarely seen in such a setting and it is usually caused by resection of part of the bone for surgical clearance, followed by post-operative radiotherapy. This condition warrants aggressive treatment, in order to avoid potentially life threatening intracranial complications. In this report, we are presenting an uncommon case of extensive osteoradionecrosis which involved the entire temporal bone, in a patient who was treated for mucoepidermoid carcinoma of parotid twelve years ago, with total conservative parotidectomy and adjuvant radiotherapy. CASe RepoRTA 66-year-old lady, a known diabetic and hypertensive, presented to our head and neck Surgical Oncology Out-Patients Department with complaints of a painless mass in the right ear canal, present since the past 2 years, intermittent right ear discharge since the past 1 year and discharge from behind the ear since the past 3 months. The discharge was foul smelling and occasionally blood stained. She had been taking local treatment in the form of ear drops on and off for her symptoms, but the complaint persisted.

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Beware bleeding from the ear

Cited by 30 publications

References 4 publications

Ruptured pseudoaneurysm following Gamma Knife surgery for a vestibular schwannoma

Ruptured pseudoaneurysm following Gamma Knife surgery for a vestibular schwannoma

Endovascular treatment of ruptured internal carotid artery pseudoaneurysms after irradiation for nasopharyngeal carcinoma patients

Diffuse Osteoradionecrosis of Temporal Bone as a Late Complication of Adjuvant Radiotherapy to Parotid Bed: A Case Report

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