Duplication of internal carotid artery: a rare case of tympanic mass

Aladwan, Abdelhamid; Mack, Martin G.; Gstöttner, Wolfgang; Vogl, Thomas J.

doi:10.1007/s00330-004-2507-x

Cited by 9 publications

(6 citation statements)

References 9 publications

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“…However, a tympanic mass due to an aberrant ICA looks different from a glomus tumor: anterior, pulsatile, and white or rosy, but it is not always pulsatile such in this case. After a careful assessment of the patient, if the surgeon has any clinical doubt about the possibility of an aberrant ICA, a CT scan of the temporal bone should be performed before any middle ear surgery [5, 12]. …”

Section: Discussionmentioning

confidence: 99%

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

Müderris¹,

Berçin

Sevil³

et al. 2013

Case Reports in Otolaryngology

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Aberrant internal carotid artery (ICA) is a rare but a very important vascular anomaly of temporal bone. Misdiagnosis of the anomaly may lead to massive hemorrhage and severe complications during otologic procedures. It is essential to keep this anomaly in mind for any otologic surgeon to prevent catastrophic complications. We present a case of aberrant ICA appeared as a nonpulsatile middle ear mass. The patient had a complaint of hearing loss, and the otoscopic examination of the patient revealed a tympanic membrane perforation and a blue-reddish retrotympanic mass. Multidetector computed tomography (MDCT) is a useful tool that may provide excellent visualization of temporal bone for the diagnosis of aberrant ICA. Otolaryngologists should be aware of the possibility of a vascular anomaly of temporal bone when a patient presents with a blue-reddish mass in the middle ear.

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Section: Discussionmentioning

confidence: 99%

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

Müderris¹,

Berçin

Sevil³

et al. 2013

Case Reports in Otolaryngology

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“…Audiometric results may be normal or show a conductive hearing loss due to malleus or incus blockage, associated middle-ear disease or a persistent stapedial artery. After a careful evaluation of the patient, if the surgeon has any clinical doubt about the possibility of an aberrant ICA, a CT scan of the temporal bone should ideally be performed before any middle-ear surgery 2 , 3 …”

Section: Discussionmentioning

confidence: 99%

“…However, its clinical symptoms and signs are often non-specific and require radiological investigation to distinguish between glomus tumours, other vascular malformations (aneurysms, pseudoaneurysms, haemangiomas and dehiscent jugular bulb) and otosclerosis. A blue-reddish mass behind the tympanic membrane, hearing loss and a pulsatile tinnitus are typical symptoms which should lead the otologist to the correct diagnosis 2 , 3 …”

Section: Introductionmentioning

confidence: 99%

An aberrant internal carotid artery in the temporal bone presenting as a middle-ear mass: a case report

et al. 2007

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“…In particular, aberrant ICA injury has been reported in cases of routine or exploratory myringotomy among adults, [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] as well as children. 1,9,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Though rare, certain patterns have been detected across aberrant ICA cases.…”

Section: Introductionmentioning

confidence: 99%

Laceration of Aberrant Internal Carotid Artery Following Myringotomy: A Case Report and Review of Literature

Wadhavkar

Goldrich

Roychowdhury

et al. 2021

Ann Otol Rhinol Laryngol

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Introduction: The presence of an aberrant internal carotid artery (ICA) in the middle ear is rare. Patients may be asymptomatic or complain of conductive hearing loss, otalgia, pulsatile tinnitus, or aural fullness. Otoscopic exam findings can include a pulsating erythematous lesion on the tympanic membrane (TM). It may be misdiagnosed as a glomus tumor, hemangioma, or serous otitis media, or go unrecognized until surgical exploration. Early recognition is important as intraoperative discovery carries risk of iatrogenic injury, hemorrhage and subsequent neurologic sequelae. Prevention requires adequate preoperative suspicion and can be confirmed with radiologic examination via computed tomography (CT) scan or magnetic resonance angiography (MRA). Management of iatrogenic injury of an aberrant ICA can include packing, vessel embolization and/or surgical ligation. Patient case: We report the case of an aberrant ICA injury in a pediatric patient undergoing a myringotomy with tube placement, who sustained neurologic deficits that eventually resolved following treatment with packing and coil embolization. Discussion and conclusions: An aberrant ICA can cause life-threatening complications without prior diagnosis in a routine myringotomy. Suspicious exam findings should prompt temporal bone CT to rule out aberrant ICA or other vascular pathology of the middle ear prior to surgery. In the case of iatrogenic injury of an aberrant ICA, there is no consensus in existing literature on optimal management. We reviewed 37 studies to compare therapeutic options and subsequent outcomes. Though complications are rare regardless of management, cases in which solely packing was utilized demonstrated an increased incidence of hemiparesis, aphasia, hearing loss, re-bleeding, and delayed pseudoaneurysm, as compared to an approach coupling packing with embolization or ligation, both of which have comparable outcomes.

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Duplication of internal carotid artery: a rare case of tympanic mass

Abstract: We report a case of a 30-year-old female patient evaluated for a right retrotympanic polyp found at otoscopy. During biopsy, a severe hemorrhage occurred. During computed tomography and angiography, the diagnosis of a duplication of internal carotid artery was made.

Cited by 9 publications

References 9 publications

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

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

An aberrant internal carotid artery in the temporal bone presenting as a middle-ear mass: a case report

Laceration of Aberrant Internal Carotid Artery Following Myringotomy: A Case Report and Review of Literature

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