title: Persistent stapedial artery with stapes ankylosis.
abstract: 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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sugimoto
authors.affiliation: Pediatric Otolaryngology, Jichi Children's Medical Center Tochigi, Jichi Medical University, Japan. Electronic address: makoto-ito@jichi.ac.jp.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ito
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Miyako
authors.initials: M
authors.lastname: Hatano
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Yoshizaki
mesh_terms: D000293:Adolescent; D000844:Ankylosis / Q000150:complications / Q000601:surgery*; D001158:Arteries / Q000002:abnormalities*; D005260:Female; D006314:Hearing Loss, Conductive / Q000209:etiology / Q000601:surgery*; D006801:Humans; D009998:Ossicular Prosthesis; D013198:Stapedius / Q000098:blood supply*; D013199:Stapes; D013201:Stapes Surgery / Q000379:methods*
keywords: Malleus-stapedotomy; Persistent stapedial artery