Affiliations 

  • 1 Department of Otorhinolaryngology, U niversiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • 2 Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
Otol Neurotol, 2021 Jan;42(1):e82-e85.
PMID: 33156236 DOI: 10.1097/MAO.0000000000002865

Abstract

OBJECTIVE: To describe surgical management for transcanal endoscopic ear surgery (TEES) in two patients with aberrant internal carotid artery (ICA) in the middle ear.

PATIENTS: A young girl who complained of pulsatile tinnitus and an elderly man who presented with ear bleeding. Otoendoscopy examination revealed a pulsatile reddish mass protruding through the tympanic membrane in both patients.

INTERVENTIONS: A combination of clinical assessments and imaging supported the diagnosis of aberrant ICA in the middle ear. Transcanal endoscopic reinforcement of the artery was performed; tragal cartilage was used as a shield to strengthen the carotid canal defect.

RESULTS: Assisted by fine endoscopic instruments, the protruding arteries were separated without damage to the surrounding structures and reinforced using tragal cartilage. Both patients' symptoms improved postoperatively; they reported tinnitus relief and hearing improvement.

CONCLUSION: To prevent catastrophic events, diagnosis of aberrant ICA is important before any surgical intervention. With appropriate management, surgical intervention using transcanal endoscopic ear surgery offers a clear view of the surgical field and is an excellent choice for management of aberrant ICA.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.