Grammatica Alberto, Alicandri-Ciufelli Matteo, Molteni Gabriele, Marchioni Daniele, Presutti Livio
Otolaryngology Department, University Hospital of Modena, Via del Pozzo 71, 41100, Modena, Italy.
Surg Radiol Anat. 2010 Feb;32(2):171-4. doi: 10.1007/s00276-009-0527-6. Epub 2009 Jun 25.
Variations in the course of the subarcuate artery (SAA) and of its related funnel are infrequent and asymptomatic. We present a case of a 15-year-old girl with a preverbal severe bilateral hearing loss and a subarcuate canal with an unusual course and atypical correlation with the adjacent anatomical structures, particularly with the lateral semicircular canal and the facial nerve. The variation proposed in this case, not previously reported in the literature consulted, can have important implications during middle ear surgical procedures, particularly for the retro-facial tympanoplasty approach: in fact otologic surgeons should consider any kind of variation of the SAA in surgical planning to avoid unexpected hemorrhages. The CT-scan, particularly HRCT, is a very useful tool for the study of intrapetrous vessels and their funnels, and should be considered mandatory in the case of a posterior approach to the tympanic cavity.
弓下动脉（SAA）及其相关漏斗走行的变异并不常见且无症状。我们报告一例15岁女童，存在语前严重双侧听力损失，其弓下管走行异常，与相邻解剖结构，特别是与外侧半规管和面神经的关联不典型。本病例中提出的变异在查阅的文献中未曾报道过，在中耳手术过程中可能具有重要意义，尤其是对于面神经后鼓室成形术入路：事实上，耳科外科医生在手术规划时应考虑SAA的任何变异，以避免意外出血。CT扫描，特别是高分辨率CT（HRCT），是研究岩骨内血管及其漏斗的非常有用的工具，对于鼓室后入路的情况应视为必需。
