Persistent stapedial artery with stapes ankylosis
Persistent stapedial artery with stapes ankylosis
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DOI：
10.1016/j.anl.2014.05.024
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发表时间：
2014-12-01
影响因子：
1.7
通讯作者：
Yoshizaki, Tomokazu
中科院分区：
文献类型：
--
作者：
Sugimoto, Hisashi;Ito, Makoto;Yoshizaki, Tomokazu
腓总动脉(PSA)是一种罕见的先天性血管畸形。它表现为搏动性中耳肿块，有时会导致传导性听力损失。PSA的诊断总是偶然的，因为它是如此罕见和难以预测。CT表现包括面神经鼓室段缺失棘孔和软组织隆起。手术的风险包括面瘫、PSA凝固导致的偏瘫，以及在颈内动脉变异的情况下，手术中因颈动脉损伤而导致的出血。在这篇文章中，我们报告了一例PSA合并踝关节僵硬的病例，我们使用特氟龙钢丝活塞进行了锤骨切开术。我们没有凝结PSA。然而，PSA附着在假体上，患者的听力水平有了显著的改善，没有脉动性耳鸣的主诉。因此，我们已经证明，假体附着在PSA上并不一定干扰PSA耳硬化症患者锤骨切开术后听力水平的改善。根据我们的经验，许多病例可以在不凝结PSA的情况下通过使用假体的椎骨切开术来治疗。(C)2014爱思唯尔爱尔兰有限公司。保留所有权利。
The persistent stapedial artery (PSA) is a very rare, congenital, vascular anomaly. It presents as a pulsatile middle ear mass and sometimes causes conductive hearing loss. The diagnosis of the presence of a PSA is always accidental, because it is so rare and difficult to predict. CT findings include the absence of the foramen spinosum and a soft-tissue prominence in the region of the tympanic segment of the facial nerve. The risks of surgery include facial palsy, hemiplegia caused by coagulation of the PSA, and bleeding due to injury of the carotid artery during surgery in cases of aberrant internal carotid. In this article we report a case of PSA with stapes ankylosis for which we performed malleus-stapedotomy using a Teflon wire piston. We did not coagulate the PSA. Nevertheless the PSA attached to the prosthesis, the patient presented significant improvement in hearing level and had no complaint of pulsating tinnitus. Thus, we have shown that attachment of the prosthesis to the PSA does not necessarily disturb improvement of hearing level after malleus-stapedotomy for otosclerosis with PSA. Based on our experience, many cases can be treated by stapedotomy using a prosthesis and without coagulating the PSA. (C) 2014 Elsevier Ireland Ltd. All rights reserved.