Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2021; 9(36): 11443-11447
Published online Dec 26, 2021. doi: 10.12998/wjcc.v9.i36.11443
Ear ischemia induced by endovascular therapy for arteriovenous fistula of the sigmoid sinus: A case report
Wei Li, Sui-Sui Zhang, Xiao-Ran Gao, You-Xiang Li, Hui-Jian Ge
Wei Li, You-Xiang Li, Hui-Jian Ge, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
Wei Li, Sui-Sui Zhang, Xiao-Ran Gao, Department of Neurosurgery, The Second Affiliated Hospital of Xingtai Medical College, Xingtai 054000, Hebei Province, China
Author contributions: Li W and Ge HJ contributed equally to this work; Li W, Li YX, and Ge HJ designed the research study; Li W, Zhang SS, and Gao XR performed the research; Li W and Ge HJ contributed new reagents and analytic tools; Li W, Li YX, and Ge HJ analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this case report and accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui-Jian Ge, MD, Doctor, Beijing Neurosurgical Institute, Capital Medical University, No. 119 Nansihuan West Road, Fengtai District, Beijing 100070, China. yushengge@sina.com
Received: July 22, 2021
Peer-review started: July 22, 2021
First decision: September 1, 2021
Revised: September 9, 2021
Accepted: November 14, 2021
Article in press: November 14, 2021
Published online: December 26, 2021
Processing time: 154 Days and 8.3 Hours
Abstract
BACKGROUND

Arteriovenous fistula of the sigmoid sinus is an abnormal connection of arteries with the sigmoid sinus. Endovascular treatments of such lesions are considered safe and with low rates of complications.

CASE SUMMARY

A 62-year-old female patient underwent endovascular treatment of an arteriovenous fistula of the right sigmoid sinus on February 7, 2017, but her tinnitus was not cured. She was admitted to the Beijing Tiantan Hospital, Capital Medical University, on March 20, 2017, and her pre-operative diagnosis, by digital subtraction cerebral angiography, was arteriovenous fistula of the sigmoid sinus. She underwent endovascular embolization of the distal occipital artery and posterior auricular artery using Onyx-18. The arteriovenous fistula of the sigmoid sinus was cured, and her tinnitus disappeared, but ischemia of the upper 2/3 of the right auricle occurred without hearing loss. The patient received treatment to improve microcirculation, in addition to fluid supplementation, analgesia, and hyperbaric oxygen, and the swelling due to ischemia in the right auricle did not progress further. The patient reported no tinnitus , and the right auricle had returned to normal 3 years later.

CONCLUSION

Ischemic complications of vital organs should be considered when performing embolization procedures for arteriovenous fistulas of cerebral sinuses. Compensation of the organs should be evaluated before the operation, and the related treatment regimens should be planned.

Keywords: Arteriovenous fistula; Sigmoid sinus; Posterior auricular artery; Endovascular treatment; Tinnitus; Case report

Core Tip: A 62-year-old female patient underwent endovascular treatment of an arteriovenous fistula of the right sigmoid sinus, but her tinnitus was not cured. She was admitted to the Beijing Tiantan Hospital, Capital Medical University, on March 20, 2017. She underwent endovascular embolization of the distal occipital artery and posterior auricular artery using Onyx-18. The arteriovenous fistula of the sigmoid sinus was cured, and her symptoms of tinnitus disappeared, but ischemia of the upper 2/3 auricle of the right auricle occurred without hearing loss. Ischemic complications of vital organs should be considered when performing embolization procedures for arteriovenous fistulas of cerebral sinuses.