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J Laryngol Otol ; 126(9): 923-7, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22874530

RESUMO

OBJECTIVE: We report an interesting case of a right temporal pre-auricular arteriovenous fistula (cirsoid aneurysm) causing intractable tinnitus successfully managed by transarterial n-butyl cyanoacrylate glue embolisation. CASE REPORT: A 52-year-old female presented with a one-year history of tinnitus and pulsatile swelling in the right pre-auricular region. A colour Doppler ultrasound test and magnetic resonance angiography revealed a high-flow scalp arteriovenous fistula with a feeder vessel from the distal superficial temporal artery, which drained into the corresponding, dilated, tortuous vein. The patient underwent diagnostic digital subtraction angiography. This was followed by transarterial embolisation of the fistula using a 50 per cent mixture of n-butyl cyanoacrylate glue and Lipiodol®, with manual distal venous occlusion. A successful outcome was achieved with instant relief of symptoms. CONCLUSION: Cirsoid aneurysms of the facial region, an uncommon cause of tinnitus, can be effectively managed by endovascular embolisation. This treatment obviates the need for surgery, which is associated with an increased risk of complications such as scarring, deformity and bleeding.


Assuntos
Fístula Arteriovenosa/complicações , Embolização Terapêutica/métodos , Artérias Temporais/anormalidades , Zumbido/etiologia , Angiografia/métodos , Fístula Arteriovenosa/diagnóstico , Fístula Arteriovenosa/terapia , Embucrilato/uso terapêutico , Óleo Etiodado/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , Couro Cabeludo/irrigação sanguínea , Zumbido/terapia , Resultado do Tratamento , Ultrassonografia Doppler em Cores
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