Korean J Otolaryngol-Head Neck Surg.  2006 May;49(5):561-564.

One Case of Persistent Stapedial Artery Combined with Aberrant Internal Carotid Artery

• Lee SH
• Yoon SW
• Choi SH
• Jeong HM

Abstract

A 2-year-old girl had 2-month history of both secretory otitis media . Nine weeks after the first visit, physical examination revealed a whitish mass behind the intact right tympanic membrane. A CT study showed absence of the right foramen spinosum. The right ICA had an aberrant course running laterally in the middle ear cavity with ossesous canal. The soft tissue density in the normal location of the tympanic segment of facial nerve was markedly enlarged. A diagnosis of aberrant ICA and persistent stapedial artery was made. Vascular mass in the middle ear space are very uncommon. They continue to present a diagnostic problem, as the clinical symptoms and signs are often nonspecific and require radiological investigation to distinguish between glomus tumors, other vascular tumors, a dehiscent jugular bulb and an aberrant internal carotid artery. In approximately one per cent of the population, a dehiscent ICA canal is present and can result in the passing of an aberrant ICA through the middle ear space. The persistent stapedial artery is a rare congenital vascular anomaly that may present as a pulsatile middle ear mass or that may appear as an incidental finding. It is important for the otologist to be aware of this anomaly, as a misdiagnosis can have catastrophic consequences.

Keyword

Middle ear; Internal carotid artery; Computed tomography

MeSH Terms

Arteries*
Carotid Artery, Internal*
Child, Preschool
Diagnosis
Diagnostic Errors
Ear, Middle
Facial Nerve
Female
Glomus Tumor
Humans
Incidental Findings
Otitis Media with Effusion
Physical Examination
Running
Tympanic Membrane