Persistent stapedial artery

Case contributed by Dr Chris O'Donnell


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

Patient Data

Age: 15
Gender: Female

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 tumors such as glomus tympanicum.  It should not be biopsed as it will bleed profusely!

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Case information

rID: 33222
Published: 4th Jan 2015
Last edited: 16th Jul 2018
System: Head & Neck
Inclusion in quiz mode: Included

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