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Cirsoid aneurysm of the right pre-auricular region: an unusual cause of tinnitus managed by endovascular glue embolisation

Published online by Cambridge University Press:  05 July 2012

A Kumar ,
C K Ahuja ,
N Khandelwal  and
J B Bakshi
A Kumar*
Affiliation:
Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
C K Ahuja
Affiliation:
Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
N Khandelwal
Affiliation:
Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
J B Bakshi
Affiliation:
Department of Otolaryngology and Head Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
*
Address for correspondence: Dr Ajay Kumar, Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India160012 E-mail: ajay2509@gmail.com
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Abstract

Objective:

We report an interesting case of a right temporal pre-auricular arteriovenous fistula (cirsoid aneurysm) causing intractable tinnitus successfully managed by transarterial n-butyl cyanoacrylate glue embolisation.

Case report:

A 52-year-old female presented with a one-year history of tinnitus and pulsatile swelling in the right pre-auricular region. A colour Doppler ultrasound test and magnetic resonance angiography revealed a high-flow scalp arteriovenous fistula with a feeder vessel from the distal superficial temporal artery, which drained into the corresponding, dilated, tortuous vein. The patient underwent diagnostic digital subtraction angiography. This was followed by transarterial embolisation of the fistula using a 50 per cent mixture of n-butyl cyanoacrylate glue and Lipiodol®, with manual distal venous occlusion. A successful outcome was achieved with instant relief of symptoms.

Conclusion:

Cirsoid aneurysms of the facial region, an uncommon cause of tinnitus, can be effectively managed by endovascular embolisation. This treatment obviates the need for surgery, which is associated with an increased risk of complications such as scarring, deformity and bleeding.

Keywords

TinnitusEmbolization, TherapeuticCyanoacrylatesArteriovenous Fistula
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 9 , September 2012 , pp. 923 - 927
Copyright
Copyright © JLO (1984) Limited 2012

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