지속성 등골동맥과 동반된 중이 내 미입내경동맥 1례

Abstract

A 2-year-old girl had 2-month history of both secretory otitis media . Nine weeks after the first visit, physical examination revealeda whitish mass behind the intact right tympanic membrane. A CT study showed absence of the right foramen spinosum.The right ICA had an aberrant course running laterally in the middle ear cavity with ossesous canal. The soft tissue density in thenormal location of the tympanic segment of facial nerve was markedly enlarged. A diagnosis of aberrant ICA and persistent stapedialartery was made. Vascular mass in the middle ear space are very uncommon. They continue to present a diagnostic problem,as the clinical symptoms and signs are often nonspecific and require radiological investigation to distinguish between glomus tumors,other vascular tumors, a dehiscent jugular bulb and an aberrant internal carotid artery. In approximately one per cent of thepopulation, a dehiscent ICA canal is present and can result in the passing of an aberrant ICA through the middle ear space. Thepersistent stapedial artery is a rare congenital vascular anomaly that may present as a pulsatile middle ear mass or that mayappear as an incidental finding. It is important for the otologist to be aware of this anomaly, as a misdiagnosis can have catastrophicconsequences. (Korean J Otolaryngol 2006;49:561-4)