Lazarev V A, Smirnov N A
Zh Vopr Neirokhir Im N N Burdenko. 1982 Mar-Apr(2):9-12.
The authors report on 3 patients with arterial aneurysms of the petrous part of the carotid artery which in 2 of them were manifested by profuse recurrent hemorrhages from the external acoustic meatus. The aneurysm was caused by penetrating injury of the middle ear in one patient and injury inflicted during surgery on the middle ear for purulent otitis and mastoiditis in another. Hemorrhages in the third patient occurred during exacerbation of chronic purulent inflammation of the middle ear. The diagnosis of aneurysm was made by cerebral angiography in combination with the method of substruction of the temporal bone structures. In 2 patients with aneurysms of this localization which is difficult for access were completely excluded from circulation by the endovascular method using a balloon catheter. The third patient was not operated on because of spontaneous thrombosis of the cervical segment of the carotid artery. The authors analyse the pathogenesis, clinical course, diagnosis and methods for the management of such aneurysms. They claim that the endovascular method with use of a balloon catheter is most effective for arresting the flow of blood through aneurysms of such localization and for arresting profuse hemorrhages from the external acoustic meatus.
作者报告了3例颈动脉岩部动脉瘤患者，其中2例表现为外耳道大量反复出血。1例患者的动脉瘤由中耳穿透伤引起，另1例患者的动脉瘤由中耳化脓性中耳炎和乳突炎手术时受伤所致。第3例患者的出血发生在中耳慢性化脓性炎症加重期间。通过脑血管造影结合颞骨结构减影法做出了动脉瘤的诊断。对于2例这种难以接近部位的动脉瘤患者，使用球囊导管通过血管内方法完全阻断了瘤体的血液循环。第3例患者因颈动脉颈段自发血栓形成而未接受手术。作者分析了此类动脉瘤的发病机制、临床过程、诊断及治疗方法。他们声称，使用球囊导管的血管内方法对于阻止此类部位动脉瘤的血流以及阻止外耳道大量出血最为有效。
