Persistent stapedial artery

Case contributed by Dr Chris O'Donnell

Presentation

Perforated left ear drum. ENT surgeon can see vascular mass in the middle ear cleft

Patient Data

Age: 15
Gender: Female
CT

Vascular channel (arrows) arising from the proximal carotid canal entering the middle ear cleft in the region of the cochlea prominentary and stapes then passing adjacent to the facial nerve canal to enter its own canal (parallel to the 7th canal) passing forward to the middle cranial fossa where it becomes the middle meningeal artery.

Case Discussion

The stapedial artery is an embryological vessel arising from the primitive second aortic arch that divides into a dorsal branch (the future middle meningeal artery) and a ventral division (future maxillary and mandibular arteries).  These divisions link with branches developing from the external carotid artery during the third fetal month causing the stapedial artery to regress.

If the stapedial artery persists in postnatal life, the middle meningeal artery arises from it thus the foramen spinosum (normally containing the middle meningeal) is absent.

The vessel is important to recognize as it can be confused on examination with vascular tumours such as glomus tympanicum.  It should not be biopsed as it will bleed profusely!

PlayAdd to Share

Case information

rID: 33222
Case created: 4th Jan 2015
Last edited: 30th Oct 2015
System: Head & Neck
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.