Aberrant internal carotid artery in the middle ear: a case report

Yıl 2006, Cilt: 16 Sayı: 3, 135 - 139, 30.06.2006

Raşit Midilli Nurullah Serdar Akyıldız Tayfun Kirazlı Recep Savaş

Öz

Aberrant course of the internal carotid artery within the middle ear is a rare condition. Surgical interventions following clinical or radiological misinterpretations may lead to fatal complications. A 23-year-old female patient presented with a hearing impairment of 10- month duration. On otoscopic examination, the left tympanic membrane was intact, but there was a pul- satile lesion in the tympanic cavity, synchronous with the heartbeats. Pure-tone audiometric examination of the left ear showed a unilateral mixed hearing loss, especially in low frequencies. Computed tomography showed protrusion of the internal carotid artery into the middle ear from the lateral and superior aspects of the cochlea. Magnetic resonance imaging and MR- angiography showed a left-sided deviation of the left internal carotid artery near the cochlea, associated with a filling defect. The caliber of the left internal carotid artery was narrower than the right one in the middle ear, and its proximal part was thinner. A diag- nosis of aberrant internal carotid artery was made.

Anahtar Kelimeler

Carotid artery, internal/abnormalities, ear, middle/abnormalities

Orta kulakta aberan internal karotid arter: Olgu sunumu

Öz

Orta kulakta aberan karotid arter nadir bir anomali- dir. Tanıda klinik ve radyolojik yanılma sonucu ya- pılan cerrahi girişimler bu hastalarda ölümcül ola- bilmektedir. On aydır sol kulakta işitme azlığı yakın- masıyla başvuran 23 yaşındaki kadın hastanın otoskopik bakısında sol kulakta timpan zar intakttı ve anteroinferior kadranda nabızla senkronize pul- sasyon izlendi. Tonal odyometride sol kulakta, özel- likle pes frekanslarda daha belirgin olmak üzere mikst tip işitme kaybı vardı. Bilgisayarlı tomografide internal karotid arterin kokleanın lateralinde ve su- periorunda orta kulağa uzanım gösterdiği belirlen- di. Manyetik rezonans görüntüleme MRG ve MR- anjiyo incelemelerinde sol internal karotid arterin kokleaya yakın bölgede, sola doğru kıvrım göster- diği ve bu bölgede dolum defekti olduğu görüldü. Orta kulakta sol internal karotid arter kalibresi sağa oranla daha küçüktü ve solda arterin proksimali normalden daha inceydi. Hastaya aberan karotid arter tanısı kondu

Anahtar Kelimeler

Karotid arter, internal/anormallik, kulak, orta/anormallik

Kaynakça

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