2023 Volume 69 Issue 2 Pages 97-103
We performed surgical treatment for a case of aberrant carotid artery in the middle ear with pulsatile tinnitus. Case：The patient was a 19-year-old woman. For several years, pulsatile tinnitus gradually increased and hearing loss appeared. A red pulsatile mass was found in the anterior lower quadrant of the tympanic membrane. Temporal bone CT and contrast-enhanced MRI revealed that the cause of the pulsatile tinnitus was an aberrant carotid artery in the middle ear. We performed surgical treatment. Intentional lateralization of the tympanic membrane was performed using sliced cartilage. Type IIIc tympanoplasty was performed using a long columella. After surgery, the pulsatile tinnitus disappeared and the conductive hearing loss improved. Intraoperative bleeding was minimal. There are controversial opinions regarding the surgical treatment of this disease. However, there is no significant risk when surgery is performed after an adequate preoperative evaluation. Intentional lateralizing of the tympanic membrane and reconstruction of the ossicles using a long columella may be effective for eliminating pulsatile tinnitus and improving conductive hearing loss.
