Document Detail


Bilateral duplicated internal carotid arteries presenting as middle ear masses: a case report and review of the literature.
MedLine Citation:
PMID:  22953658     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We seek to describe an individual with bilateral duplicated internal carotid arteries (ICAs) presenting as middle ear masses, to discuss the anatomy and characteristic imaging findings associated with this condition, and to familiarize clinicians with effective methods to prevent and manage complications related to this entity.
METHODS: The clinical presentation of an individual with this unusual vascular anomaly was reviewed. A literature search was then performed to identify previously reported studies describing aberrant ICAs in order to characterize the presentation, anatomy, imaging findings, and management of this condition.
RESULTS: An aberrant ICA presenting as a middle ear mass is uncommon; there are only approximately 45 reported cases to date. The majority of these cases presented as a unilateral anomaly without a duplication, were associated with pulsatile tinnitus and hearing loss, and were diagnosed during middle ear procedures. Bilateral aberrant ICAs are exceedingly rare, with only 14 existing reports. Only 1 of these cases presented with duplicated ICAs. Our report demonstrates an unusual presentation of aberrant ICAs, as pulsatile tinnitus was absent and previous middle ear surgery had been performed without establishing this diagnosis and without any resulting complications. Furthermore, this case represents the first known instance of a bilateral duplicated ICA system without persistent stapedial arteries. Although vascular middle ear anomalies are unusual, complications of surgical manipulation have been documented.
CONCLUSIONS: The clinician must have a high index of suspicion for vascular lesions in patients presenting with a retrotympanic mass. Appropriate diagnostic imaging studies should be performed to exclude this diagnosis before middle ear exploration. Should injury to the carotid artery occur, surgeons should follow specific guidelines to avoid potentially serious complications.
Authors:
Brian C Gartrell; Tabassum A Kennedy; Samuel P Gubbels
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural; Review    
Journal Detail:
Title:  The Annals of otology, rhinology, and laryngology     Volume:  121     ISSN:  0003-4894     ISO Abbreviation:  Ann. Otol. Rhinol. Laryngol.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-09-07     Completed Date:  2012-11-01     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  0407300     Medline TA:  Ann Otol Rhinol Laryngol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  521-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Division of Otolaryngology, University of Wisconsin Hospital and Clinics, Madison, Wisconsin 53792-7375, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Carotid Artery, Internal / abnormalities*,  pathology
Hearing Aids
Hearing Loss, Mixed Conductive-Sensorineural / etiology,  therapy
Humans
Imaging, Three-Dimensional
Magnetic Resonance Angiography
Male
Otitis Media / complications,  surgery
Tomography, X-Ray Computed
Grant Support
ID/Acronym/Agency:
1UL1RR025011/RR/NCRR NIH HHS; UL1 RR025011/RR/NCRR NIH HHS
Comments/Corrections

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