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Persistent stapedial artery: does it prevent successful surgery?

P J Govaerts1, T F Marquet, W R Cremers

  • 1Department of Otolaryngology, University Hospital Nijmegen, The Netherlands.

The Annals of Otology, Rhinology, and Laryngology
|September 1, 1993
PubMed
Summary

The persistent stapedial artery, often found during middle ear surgery, may not cause significant complications if injured. Surgeons can proceed with tympanotomy without excessive caution regarding this embryologic remnant.

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Area of Science:

  • Otolaryngology
  • Embryology
  • Vascular Surgery

Background:

  • The embryologic stapedial artery is a remnant vessel with a presumed important function.
  • Surgeons often exercise extreme caution during middle ear surgery upon encountering a persistent stapedial artery.
  • Discontinuation of surgery is sometimes recommended due to theoretical concerns about damaging this artery.

Observation:

  • This study reviews the embryology and literature concerning the persistent stapedial artery.
  • Four cases of persistent stapedial artery were identified in nearly 20,000 tympanotomy procedures.
  • Literature focusing on iatrogenic injury to the persistent stapedial artery was specifically examined.

Findings:

  • Injury to the persistent stapedial artery during middle ear surgery likely results in minimal to no significant postoperative complications.

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  • Complete transection of the persistent stapedial artery is also unlikely to cause major sequelae.
  • The presence of a persistent stapedial artery does not necessitate the hindrance or discontinuation of middle ear surgery.

    • Implications:

    • Surgical management of middle ear conditions can proceed with less apprehension when a persistent stapedial artery is identified.
    • Clinical evidence suggests that the theoretical risks associated with damaging the persistent stapedial artery are overstated.
    • This study provides a basis for revising surgical protocols regarding the persistent stapedial artery, potentially improving surgical efficiency and patient outcomes.