title: Cirsoid aneurysm of the right pre-auricular region: an unusual cause of tinnitus managed by endovascular glue embolisation.
abstract: OBJECTIVE
  We report an interesting case of a right temporal pre-auricular arteriovenous fistula (cirsoid aneurysm) causing intractable tinnitus successfully managed by transarterial n-butyl cyanoacrylate glue embolisation.
  
  
  METHODS
  A 52-year-old female presented with a one-year history of tinnitus and pulsatile swelling in the right pre-auricular region. A colour Doppler ultrasound test and magnetic resonance angiography revealed a high-flow scalp arteriovenous fistula with a feeder vessel from the distal superficial temporal artery, which drained into the corresponding, dilated, tortuous vein. The patient underwent diagnostic digital subtraction angiography. This was followed by transarterial embolisation of the fistula using a 50 per cent mixture of n-butyl cyanoacrylate glue and Lipiodol®, with manual distal venous occlusion. A successful outcome was achieved with instant relief of symptoms.
  
  
  CONCLUSIONS
  Cirsoid aneurysms of the facial region, an uncommon cause of tinnitus, can be effectively managed by endovascular embolisation. This treatment obviates the need for surgery, which is associated with an increased risk of complications such as scarring, deformity and bleeding.
authors.affiliation: Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India. ajay2509@gmail.com
authors.forename: A
authors.initials: A
authors.lastname: Kumar
authors.forename: C K
authors.initials: CK
authors.lastname: Ahuja
authors.forename: N
authors.initials: N
authors.lastname: Khandelwal
authors.forename: J B
authors.initials: JB
authors.lastname: Bakshi
mesh_terms: D000792:Angiography / Q000379:methods; D001164:Arteriovenous Fistula / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000627:therapeutic use; D004998:Ethiodized Oil / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D012535:Scalp / Q000098:blood supply; D013699:Temporal Arteries / Q000002:abnormalities*; D014012:Tinnitus / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
chemical_list: D004998:Ethiodized Oil; D004659:Enbucrilate