Abstract
Persistent stapedial artery, one of the rare arterial congenital anomalies of the middle ear, is important to know due to its possible clinical repercussions. Ignoring its existence may lead to complications during surgery of the middle ear (notably hemorrhage). Exploration of the vascular malformation is rendered possible via high-definition computed tomography (CT) imaging of the petrous bones, which reveals the frequent bilaterality of this anatomical variation as well as the presence of associated anomalies. We report on two cases of persistent stapedial artery discovered during CT scan explorations.
Highlights
Persistent stapedial artery, one of the rare arterial congenital anomalies of the middle ear, is important to know due to its possible clinical repercussions
computed tomography (CT) imaging in fine slices with multiplanar reconstructions revealed a small tubular mass 4mm in size, exiting from the angle of the internal carotid artery and passing between the branches of the stirrup (Fig. 1) before joining the tympanic segment of the facial nerve channel (Fig. 2)
Persistent stapedial artery is a rare vascular anomaly, with a prevalence estimated to be between 0.02% and 0.05% in a surgical series [1] and slightly higher in a study focused on the temporal bone [2]
Summary
A 36-year-old patient presented with hypoacousia of the right ear, evolving for over one year. CT imaging in fine slices with multiplanar reconstructions revealed a small tubular mass 4mm in size, exiting from the angle of the internal carotid artery and passing between the branches of the stirrup (Fig. 1) before joining the tympanic segment of the facial nerve channel (Fig. 2). There was no spiny foramen (not illustrated). A CT scan of the petrous bones was performed on a 6-year-old child. The absence of spiny foramen was bilateral (Fig. 3). A small tubular structure showing a cranial-caudal path was visible from the promontory, in front of the fenestra vestibuli, in contact with the anterior branch of the stirrup and rejoining the enlarged facial channel in a bilateral manner (Fig. 4).
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