ABSTRACT
The persistence of the stapedial artery is a rare vascular anomaly. It is mostly asymptomatic but sometimes cause conductive hearing loss, pulsatile tinnitus, or vertigo. The estimated prevalence of this rare postembryonic persistence ranged from 0.02% to 0.48%. Four different anatomical forms have been identified, and their preoperative diagnostic is essential. We report the case of an incidental discovery of pharyngo-hyo-stapedial artery, the most uncommon form of persistent stapedial artery. Its per-operative finding has become rare because tomodensitometry is performed in case of conductive hearing loss. The continuous improvement of imagery resolution will probably help to revise the incidence of this malformation.
Subject(s)
Hearing Loss, Conductive/diagnosis , Stapedius/blood supply , Tinnitus/diagnosis , Tomography, X-Ray Computed , Vascular Malformations/diagnosis , Adult , Female , Hearing Loss, Conductive/congenital , Humans , Incidental Findings , Medical Illustration , Stapedius/diagnostic imaging , Tinnitus/congenitalABSTRACT
Subjective tinnitus (heard only by the patient) is a common otological complaint. Objective tinnitus (heard by the examiner as well as the patient) is extremely rare. There are only a few cases of objective tinnitus, secondary to middle-ear myoclonus, described in the literature. We present the case of a child with bilateral, congenital, objective tinnitus, secondary to middle-ear myoclonus, with otherwise normal hearing thresholds (250 Hz-8 kHz), and with no evidence of intra-cerebral or systemic disorders. No similar case has been reported in the world literature.
Subject(s)
Ear, Middle , Myoclonus/complications , Tinnitus/etiology , Audiometry, Pure-Tone , Child , Humans , Male , Myoclonus/congenital , Tinnitus/congenital , Tympanic MembraneABSTRACT
A 5-year-old boy was evaluated for a left retrotympanic mass found at otoscopy. Subsequent petrous bone CT and MR angiographic examinations demonstrated bilateral aberrant internal carotid, bilateral stapedial artery persistence, and bilateral duplicated internal carotid arteries. Imaging findings and their clinical relevance are discussed. A second case of unilateral aberrant internal carotid artery with a persistent stapedial artery is included for comparison.
Subject(s)
Carotid Artery, Internal/abnormalities , Cerebral Angiography , Dominance, Cerebral/physiology , Image Enhancement , Image Processing, Computer-Assisted , Imaging, Three-Dimensional , Intracranial Arteriovenous Malformations/diagnosis , Magnetic Resonance Angiography , Stapedius/blood supply , Tomography, X-Ray Computed , Carotid Artery, Internal/pathology , Child, Preschool , Diagnosis, Differential , Ear, Middle/blood supply , Female , Hearing Loss, Sensorineural/congenital , Hearing Loss, Sensorineural/diagnosis , Humans , Male , Otitis Media/diagnosis , Otoscopy , Petrous Bone/pathology , Tinnitus/congenital , Tinnitus/diagnosisABSTRACT
Mondini's deformity is the second most common malformation seen in congenital genetic deafness. It is characterized by bony and membranous abnormalities of the inner ear, with a wide range of morphological and functional abnormalities. The importance of the Mondini malformation is that the patient is at an increased risk of developing meningitis or bilateral total hearing loss (or both) at an early age. Six cases are presented which illustrate the various sequelae of the Mondini malformation including meningitis, vertigo, and auditory deterioration. Decompression of the endolymphatic sac was undertaken in three patients. Emphasis is placed on the danger of head trauma, even minor, in these patients. The necessity of early diagnosis with adequate patient counseling is stressed.
