An atypical stapedial artery.

Area of Science:

• Vascular Anatomy
• Embryology
• Otolaryngology

Background:

• Persistent stapedial artery is a rare vascular anomaly with an estimated prevalence of 0.02% to 0.48%.
• This condition can be asymptomatic or manifest as conductive hearing loss, pulsatile tinnitus, or vertigo.
• Four distinct anatomical forms have been identified, necessitating precise preoperative diagnosis.

Observation:

• This report details an incidental discovery of the pharyngo-hyo-stapedial artery, a particularly rare variant.
• Preoperative diagnosis of this specific form is uncommon, partly due to the routine use of computed tomography (CT) for conductive hearing loss evaluation.
• Surgical findings of this anomaly are becoming increasingly rare.

Findings:

• The pharyngo-hyo-stapedial artery represents the most infrequent anatomical variation of persistent stapedial artery.
• Incidental intraoperative findings are less common now with advanced diagnostic imaging techniques.
• Improved imaging resolution may lead to a reevaluation of the actual incidence of this vascular malformation.

Implications:

• Accurate preoperative diagnosis of persistent stapedial artery variants is crucial for appropriate patient management.
• Advances in imaging technology may reveal a higher prevalence of these rare vascular anomalies.
• Understanding the anatomical variations is essential for otologic surgeons and radiologists.