Pulsatile tinnitus associated with dehiscent internal carotid artery: An irremediable condition?
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.
CHU UCL Namur - Site Godinne, ENT Department/Otology Unit, Belgium. Electronic address: Jean-Philippe.Vandamme@uclouvain.be.
Jean-Philippe
JP
Van Damme
CHU UCL Namur - Site Godinne, ENT Department/Otology Unit, Belgium.
Géraldine
G
Heylen
CHU UCL Namur - Site Godinne, ENT Department/Otology Unit, Belgium.
Chantal
C
Gilain
CHU UCL Namur - Site Godinne, ENT Department/Otology Unit, Belgium; University of Namur - Anatomy Department, Belgium.
Pierre
P
Garin
D002343:Carotid Artery, Internal / Q000002:abnormalities* / Q000000981:diagnostic imaging; D004425:Ear Cartilage / Q000637:transplantation; D004432:Ear, Middle / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014012:Tinnitus / Q000209:etiology / Q000601:surgery*
Carotid artery, internal; Dehiscence; Pulsatile tinnitus; Surgical approach