A young man with conductive hearing loss, pulsatile tinnitus, and a mass behind the tympanic membrane was found to have a persistent stapedial artery and an aberrant internal carotid within the middle ear cavity. The stapedial artery is a continuation of the primitive hyoid branch of the internal carotid artery which terminates as the middle meningeal artery, but normally regresses in the 24-mm embryo. Radiographic findings of the persistent stapedial artery include absence of the foramen spinosum, a special opening for the stapedial artery in the temporal bone best seen on tomograms, and demonstration of the characteristic course of the artery on carotid angiograms.
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Guinto et al. (1972) studied this question.
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