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題 名 | 中耳腔內頸動脈異位=Aberrant Internal Carotid Artery in the Middle Ear |
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作 者 | 廖伯武; 何承峰; 陳正文; 林凱南; | 書刊名 | 臺灣耳鼻喉頭頸外科雜誌 |
卷 期 | 51:1 2016.01-03[民105.01-03] |
頁 次 | 頁63-68 |
分類號 | 416.821 |
關鍵詞 | 內頸動脈; 血管異常; 脈動性耳鳴; 中耳; Internal carotid artery; Vascular anomaly; Pulsatile tinnitus; Middle ear; |
語 文 | 中文(Chinese) |
中文摘要 | 中耳腔內頸動脈異位是一種罕見但重要的顳骨血管異常,一旦疏忽可能導致中耳手術或處置過程中大出血與嚴重的併發症,耳鼻喉科醫師必須謹記此可能的異常,以避免中耳手術時發生災難性的併發症。本文報告1名60歲女性患者,因左耳脈動性耳鳴及耳悶塞感持續1年而求診,據病患描述此耳鳴從不間斷且造成失眠。耳鏡檢查鼓膜完整,但於前下部鼓膜背後可見一淡紅色腫塊,耳鏡下持續觀察發現鼓膜出現節奏性的律動。純音聽力檢查顯示左耳出現15 dB的傳導性聽力損失,軸向及冠向高解析度顳骨電腦斷層掃描發現左側頸動脈骨板缺損,內頸動脈向中耳腔膨出進入前下鼓室,並與鼓膜直接接觸,確診為中耳腔內頸動脈異位。經告知病患診斷及中耳處置或手術可能出現的併發症後,病人選擇定期追蹤。 |
英文摘要 | Aberrant internal carotid artery (ICA) in the middle ear is a rare but an important vascular anomaly of the temporal bone. Misdiagnosis of this anomaly may result in massive hemorrhage and severe complications during middle ear procedures. It is essential to keep this anomaly in mind for any otolaryngologist to prevent catastrophic complications. We reported a 60-year-old female patient with a one-year history of pulsatile tinnitus and fullness in her left ear. The tinnitus was persistent, and made the patient suffered from insomnia. Otoscopic examination revealed an antero-inferior pinkish mass behind the tympanic membrane. The intact tympanic membrane was observed with rhythmic pulsation. Pure tone audiogram showed a 16-dB conductive hearing loss of the left ear. Axial and coronal high-resolution computed tomography of the temporal bone demonstrated protrusion of the left ICA through a dehiscent lateral carotid plate into the tympanic cavity, with direct contact with the tympanic membrane. A diagnosis of aberrant left ICA in the middle ear was made. She was informed about the diagnosis and the possible complications of inadvertent middle ear interventions. The patient was managed with regular follow-ups. |
本系統中英文摘要資訊取自各篇刊載內容。