Arterial Anomalies of the Middle Ear: A Pictorial Review with Clinical-Embryologic and Imaging Correlation

Area of Science:

• Vascular imaging
• Radiology
• Otolaryngology

Background:

• Red or pulsatile retrotympanic masses can be caused by several conditions.
• Aberrant internal carotid artery (AICA) and persistent stapedial artery (PSA) are rare vascular anomalies that can present as retrotympanic masses.
• Misidentification of these vascular anomalies can lead to severe surgical complications.

Purpose of the Study:

• To outline the diagnostic features of AICA and PSA on high-resolution computed tomography (HRCT).
• To emphasize the importance of accurate radiological assessment of these vascular anomalies.
• To discuss the classification of PSA based on its unique imaging characteristics.

Main Methods:

• Review of high-resolution computed tomography (HRCT) findings for aberrant internal carotid artery (AICA) and persistent stapedial artery (PSA).
• Analysis of imaging features differentiating these vascular anomalies from other retrotympanic masses.
• Classification of PSA based on distinct imaging patterns.

Main Results:

• HRCT allows for the identification of characteristic imaging features of AICA and PSA.
• PSA exhibits unique imaging features depending on its specific type.
• Distinguishing these vascular anomalies is key for appropriate clinical management.

Conclusions:

• Radiologists can reliably diagnose AICA and PSA using HRCT by recognizing specific imaging features.
• Accurate and consistent detection of these vascular anomalies is essential for surgical planning and patient safety.
• Understanding PSA subtypes improves diagnostic accuracy.