A Case of Temporal Bone Osteoradionecrosis Accompanied by Internal Carotid Artery Pseudoaneurysm

Radiation therapy plays a critical role in treating head and neck malignancies. However, it is associated with the potential for severe complications, including the development of osteoradionecrosis (ORN). An uncommon consequence of ORN is the emergence of pseudoaneurysms within the internal carotid artery (ICA). Pseudoaneurysms of the petrous ICA resulting from temporal ORN can lead to life-threatening bleeding, necessitating prompt interventions such as coiling, stenting, and carotid sacrifice. In instances where there exists a high risk of ICA rupture, a combination of these therapeutic approaches might be indispensable to prevent serious complications and enhance the well-being of the patients. We present a case involving a pseudoaneurysm within the petrous segment of the ICA caused by ORN. The treatment consisted of coil embolization coupled with subtotal petrosectomy and partial labyrinthectomy. Despite an initial treatment, recurrence occurred within two months, prompting the subsequent implementation of stent insertion with revisional subtotal petrosectomy.