Endovascular Treatment of a Petrous Internal Carotid Artery Aneurysm With Hemotympanum and Epistaxis Using a Coronary Stent and Detachable Platinum Coils

Horowitz, Michael; Levy, Elad I.; Hathaway, Bridget; Jovin, Tudor; Hirsch, Barry E.

doi:10.1001/archotol.131.1.61

Cited by 8 publications

(4 citation statements)

References 9 publications

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“…Other possible explanations include masked coagulation disorder, a vascular cause such as an arterial aneurysm, as described by Horowitz et al [ 19 ], or tympanomastoid or jugular paragangliomas [ 20 ], that both can lead to a hemorrhage and bloody otorrhea. In addition, while not probable, it could be that the hemotympanum was an unrelated occurrence.…”

Section: Discussionmentioning

confidence: 99%

Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth

Teitelbaum,

Shochat,

Grinblat

et al. 2023

Case Reports in Otolaryngology

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Background. Hemotympanum may occur due to otic barotrauma secondary to Valsalva maneuver during the second phase of labor. A pressure differential across the tympanic membrane (TM) of about five psi can cause rupture. The increased intrathoracic and intraabdominal pressure spikes repeatedly manifested by “pushing” during second-stage labor easily approach (and may exceed) this level. Clinical Presentation. This case report describes a healthy thirty-seven-year-old multipara patient admitted for the 40-weeks’ gestational age routine follow-up that proceeded to active labor followed by an aural fullness and bloody otorrhea. Otoscopic examination with a light microscope confirmed the hemotympanum of the right tympanic membrane. Conclusion. Forceful Valsalva can cause hemotympanum. Investigating the benefits and disadvantages of the pushing methods could help reduce such complications in the future. A prompt evaluation of an otolaryngologist should be requested in the event of a new postpartum hearing disturbance or bloody otorrhea.

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Section: Discussionmentioning

confidence: 99%

Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth

Teitelbaum,

Shochat,

Grinblat

et al. 2023

Case Reports in Otolaryngology

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“…Novel endovascular stent technologies, including coil placement with stent-assistance and covered stents, may eliminate the aneurysm while well preserving flow in the parent supply. 6) Surgical revascularization with an interpositional high-flow bypass graft is an important strategy for lesions inappropriate for endovascular treatment. The risk of rupture and bleeding, leading to a life-threatening condition is higher in patients with a pseudoaneurysm.…”

Section: Discussionmentioning

confidence: 99%

Stent-assisted Coil Embolization of Petrous ICA in a Teenager with Neurofibromatosis

Lee

Jang

Kim

et al. 2015

J Cerebrovasc Endovasc Neurosurg

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We herein report on a patient with a cerebral aneurysm located at the petrous portion of the internal carotid artery (ICA). An 18-year-old male, previously diagnosed with neurofibromatosis, was referred to our emergency service complaining of severe headache, pulsatile tinnitus, nausea, and vomiting which occurred suddenly. Neuro-radiological studies including computed tomography and magnetic resonance imaging of the cerebral artery showed a large aneurysm arising from the petrous segment of the left ICA. He was treated with a neuro-interventional technique such as intra-arterial stenting and coil embolization for the aneurysm. Several days after the interventional treatment, his symptoms were resolved gradually except for a mild headache.Symptomatic unruptured aneurysm at the petrous portion of the ICA is rare, and our patient was treated successfully using a neuro-intervention technique. Therefore, we describe a case of a petrous aneurysm treated with endovascular coils without compromising the ICA flow, and review the literature.

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“…The selection and safety of treatment modality depend on the anatomy of the aneurysm and the segment involved as well as the presence of collateral flow to brain and the clinical status of the patient. Endovascular treatment alternatives, with preservation or sacrifice of the ICA, have become the most frequently used techniques to control an active hemorrhage or to prevent fu- ture bleeding 2,5,6,7 . Carotid pseudoaneurysms caused by infection carry a high risk of rupture with a 54% mortality rate 2 .…”

Section: Discussionmentioning

confidence: 99%