TY - JOUR
T1 - Pulsatile tinnitus associated with dehiscent internal carotid artery
T2 - An irremediable condition?
AU - Van Damme, Jean Philippe
AU - Heylen, Géraldine
AU - Gilain, Chantal
AU - Garin, Pierre
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Dehiscent internal carotid artery (ICA) in the middle ear is a rare condition, with conservative treatment primarily recommended. We report the case of a 63-year-old patient referred to the Ear, Nose, and Throat (ENT) ward for unbearable pulsatile tinnitus. Otoscopy revealed a normal right tympanic membrane, with pulsatile tinnitus but without hearing impairment. Based on imaging studies, including computed tomography (CT) and magnetic resonance imaging (MRI) of the temporal bone, as well as Doppler ultrasound of the internal carotid artery and sigmoid sinus, the diagnosis of ICA canal dehiscence into the tympanic cavity was established, thus excluding the diagnosis of aberrant ICA. Following the patient's own request, we undertook surgical correction, with the technique used described in the report. Immediately postoperatively, the pulsatile tinnitus had disappeared, with no surgical complications noted. At the 9-month follow-up, otoscopy revealed a healthy right tympanic membrane and the patient reported no remaining symptoms.
AB - Dehiscent internal carotid artery (ICA) in the middle ear is a rare condition, with conservative treatment primarily recommended. We report the case of a 63-year-old patient referred to the Ear, Nose, and Throat (ENT) ward for unbearable pulsatile tinnitus. Otoscopy revealed a normal right tympanic membrane, with pulsatile tinnitus but without hearing impairment. Based on imaging studies, including computed tomography (CT) and magnetic resonance imaging (MRI) of the temporal bone, as well as Doppler ultrasound of the internal carotid artery and sigmoid sinus, the diagnosis of ICA canal dehiscence into the tympanic cavity was established, thus excluding the diagnosis of aberrant ICA. Following the patient's own request, we undertook surgical correction, with the technique used described in the report. Immediately postoperatively, the pulsatile tinnitus had disappeared, with no surgical complications noted. At the 9-month follow-up, otoscopy revealed a healthy right tympanic membrane and the patient reported no remaining symptoms.
KW - Carotid artery, internal
KW - Dehiscence
KW - Pulsatile tinnitus
KW - Surgical approach
UR - http://www.scopus.com/inward/record.url?scp=84994184664&partnerID=8YFLogxK
U2 - 10.1016/j.anl.2016.08.008
DO - 10.1016/j.anl.2016.08.008
M3 - Article
AN - SCOPUS:84994184664
SN - 0385-8146
VL - 44
SP - 612
EP - 615
JO - Auris Nasus Larynx
JF - Auris Nasus Larynx
IS - 5
ER -