Summary
A 15-year-old diabetic boy suffering from recurrent peritonsillar infections developed a mycotic aneurysm of the internal carotid artery at the base of the skull. The aneurysm was approached through a cervical and retroauricular incision. The styloid process was burred down at its base. The sternocleidomastoid muscle and the digastric muscle were resected from the mastoid. The internal carotid artery was clamped proximally and blocked with a balloon-catheter distally. The carotid bone canal was opened 10 mm and the carotid artery resected until normal vessel wall was reached. A vein graft was placed end-to-end with single stitches, using 8×0 monofil sutures with a small neddle. The postoperative course was uneventful except for a temporary paresis of the peripheral facial nerve. Postoperative angiography revealed restoration of the vessel to normal, the patient is now free of symptoms.
Zusammenfassung
Bei einem 15jährigen Jungen mit jevenilem Diabetes mellitus entwickelte sich im Zusammenhang mit einer rezidivierenden Racheninfektion ein großes schädelnahes Aneurysma im Endabschnitt der extrakraniellen A. carotis interna. Durch Eröffnung des Karotiskanals wurde ein anastomosenfähiges, distales Gefäßende hergestellt und die Strombahn durch ein autologes Veneninterponat rekonstruiert. Der postoperative Verlauf war bis auf eine periphere Faszialisparese ohne Komplikationen, die postoperative Arteriographie zeigte normale Gefäßverhältnisse.
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Sandmann, W., Aulich, A. & Edelmann, M. Aneurysma im Endabschnitt der extrakraniellen Arteria carotis interna. Arch Otorhinolaryngol 234, 285–291 (1982). https://doi.org/10.1007/BF00464333
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DOI: https://doi.org/10.1007/BF00464333
Key words
- Internal carotid artery
- Aneurysm
- Reconstructive arterial surgery
- Mycotic aneurysm
- Retropharyngeal abscess