Otology & Neurotology 39:387 – 389 2018, Otology & Neurotology, Inc. Letters to the Editor BREAKING THE MYTH OF CENTRAL NEUROLOGICAL COMPLICATIONS IN STAPEDIAL ARTERY SURGERY To the Editor: We read with great interest the review article by Goderie et al. (1) entitled ‘‘Surgical management of a persistent stapedial artery.’’ In line with the author’s opinion, we confirm the idea that the stapedial artery can be coagulated without complications. Today, no surgeon need feel any ‘‘doubt’’ when facing a persistent stapedial artery (2,3). The risk of ‘‘hemiplegia, or central auditory, or vestibular impairment’’ is not even a theory, but rather an extrapolation from an embryological study in rats, where a few animals exhibited partial dysgenesis of the basilar artery with a primitive vascular plexus vascularizing the brain- stem. As this primitive vascular plexus was anastomosed FIG. 1. Computerized tomography scan showing a stapedial with the stapedial artery, the authors hypothesized that a artery (SA) too small to be responsible for the conductive hearing persistent stapedial artery in humans might be capable of loss, but associated with a thickened footplate and demineraliza- partially vascularizing the brainstem, if associated with tion of the antefenestram. This indicates otosclerosis as the cause
Otology & Neurotology – Wolters Kluwer Health
Published: Mar 1, 2018
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