Anagiotos Andreas, Kazantzi Maria, Tapis Marios
ENT Department, Nicosia General Hospital, Nicosia, Cyprus.
Nicosia Otolaryngology Center, Nicosia, Cyprus.
BMJ Case Rep. 2019 Apr 20;12(4):e228865. doi: 10.1136/bcr-2018-228865.
Vascular variants concerning the internal carotid artery (ICA) at the skull base level are rare. Correct workup and diagnosis in case of suspicion of such a variant are important as it mimics glomus tumours and could complicate myringotomy or middle ear surgery. We report a case of a 39-year-old woman presented with a 6-month history of right pulsatile tinnitus and aural fullness. Ear microscopy examination revealed a pale red pulsatile mass anterior to the umbo. Radiological assessment using CT and MRI/magnetic resonance angiography confirmed the diagnosis of an aberrant ICA. Interestingly, a duplication of the ICA was demonstrated, in which the enlarged inferior tympanic artery presented as the aberrant ICA, whereas a narrower collateral hypoplastic native ICA was also present. A conservative approach with regular follow-up appointments was recommended.
颅底水平涉及颈内动脉（ICA）的血管变异很少见。怀疑存在此类变异时进行正确的检查和诊断很重要，因为它可模仿颈静脉球瘤，并且可能使鼓膜切开术或中耳手术复杂化。我们报告一例39岁女性，有6个月的右搏动性耳鸣和耳闷病史。耳镜检查发现鼓膜脐部前方有一个淡红色搏动性肿物。使用CT和MRI/磁共振血管造影进行的影像学评估证实了异常ICA的诊断。有趣的是，发现ICA存在重复，其中扩大的下鼓室动脉表现为异常ICA，同时还存在较窄的侧支发育不全的原始ICA。建议采用保守方法并定期随访。
