Skip to main content
Log in

Persistent stapedial arteries in human: from phylogeny to surgical consequences

  • Review
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

The stapedial artery is an embryonic artery which disappears during the tenth week in utero, in human species. During its short life, this artery shapes the stapes and transforms the middle meningeal artery from the internal carotid artery to a branch of the external carotid system. Nevertheless, a persistent stapedial artery is seen in 0.2–4.8 per thousand of human adults. This persistence is usually asymptomatic but can sometimes cause pulsatile tinnitus or conductive hearing loss. Despite the risk of facial palsy, hearing loss and even hemiplegia argued by several authors, some surgeons have succeeded in coagulation without side effects. Reviewing the literature, we seek to enlighten the actual knowledge about the persistent stapedial artery to evaluate the risk to coagulate it. Embryologic studies explain the four types of persistent stapedial arteries: the hyoido-stapedial artery, the pharyngo-stapedial artery, the pharyngo-hyo-stapedial artery and aberrant internal carotid with persistent stapedial artery. Phylogenetic studies show that the stapedial artery persists in adulthood in many vertebrates. Its disappearance is therefore either a random effect or an adaptative convergence. This adaptation could be partially linked to the negative allometry of the stapes. Practically, the risk to coagulate a stapedial artery seems limited thanks to anastomoses, for example with the stylomastoid artery. The risk of hemiplegia reported is in fact an extrapolation of variation in rats’ embryos. A persistent stapedial artery can therefore reasonably be coagulated, with special attention to the facial nerve, because the facial canal is always dehiscent where the artery penetrates.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Adachi B, Hasebe K (1928) Arteriensystem der Japaner. Verlag der Kai serlich-Japanische Universität zu Kyoto, kyoto

  2. Alexander G (1899) Ein Fall von Persistenz der Arteria Stapedia beim Menschen. Monatsschr Ohrenheilkd Laryngorhinol 33:273–276

    Google Scholar 

  3. Altman F (1947) Anomalies of the internal carotid artery and its branches; their embryological and comparative anatomical significance: report of a new case of persistent stapedial artery in man. Laryngoscope 57(5):313–339

    Google Scholar 

  4. Ardouin P (1934) Considérations anatomiques sur les osselets de l’ouïe chez certains singes anthropomorphes. Bulletins et Mémoires de la Société d’anthropologie de Paris 5(1):20–47

    Article  Google Scholar 

  5. Bininda-Emonds ORP, Cardillo M, Jones KE, MacPhee RDE, Beck RMD, Grenyer R et al (2007) The delayed rise of present-day mammals. Nature 446:507–512

    Article  PubMed  CAS  Google Scholar 

  6. Bossy J (1959) Recherches sur les vestiges de l’artere stapedienne chez l’homme. Arch Anat Histol Embryol(Strasb) 42:145–150

    Google Scholar 

  7. Brock W (1922) Drei neue Faelle von persistierender arteria stapedia beim menschen. Monatsschrift für Ohrenheilkunde 56:683–685

    Google Scholar 

  8. Celebi I, Oz A, Yildirim H, Bankeroglu H, Basak M (2012) A case of an aberrant internal carotid artery with a persistent stapedial artery: association of hypoplasia of the A1 segment of the anterior cerebral artery. Surg Radiol Anat 34:665–670

    Article  PubMed  Google Scholar 

  9. Conroy GC, Armstrong E, Falk D (1982) Primate brain evolution. Plenum, New York

    Google Scholar 

  10. Diamond MK (1989) Coarctation of the stapedial artery: an unusual adaptive response to competing functional demands in the middle ear of some eutherians. J Morphol 200(1):71–86

    Article  PubMed  CAS  Google Scholar 

  11. Friderun A-S (2000) Primate anatomy: an introduction. London Academic Press, London

    Google Scholar 

  12. Govaerts PJ, Marquet TF, Cremers C, Offeciers FE (1993) Persistent stapedial artery: does it prevent successful surgery? Ann Otol Rhinol Laryngol 102:724–728

    PubMed  CAS  Google Scholar 

  13. Grassé P-P (1954) Vertébrés : embryologie, grands problèmes d’anatomie comparée, caractéristiques biochimiques, in Traité de Zoologie, anatomie, systematique, biologie, vol XII. Masson, Paris, pp 1503–15011

    Google Scholar 

  14. Hanken J, Hall BK (1993) Functional and evolutionary mechanisms, in The skull. University of Chicago Press, Chicago

    Google Scholar 

  15. Hitier M, Besnard S, Vignaux G, Denise P, Moreau S (2010) The ventrolateral surgical approach to labyrinthectomy in rats: anatomical description and clinical consequences. Surg Radiol Anat 32:835–842

    Article  PubMed  CAS  Google Scholar 

  16. Hitier M, Edy E, Salame E, Moreau S (2007) Anatomie du nerf facial. EMC-Oto-rhino-laryngologie 36:1–16

    Google Scholar 

  17. Hogg ID, Stephens CB, Arnold GE (1972) Theoretical anomalies of the stapedial artery. Ann Otol Rhinol Laryngol 81:860–870

    PubMed  CAS  Google Scholar 

  18. Hunt RM (2005) The auditory bulla in Carnivora: an anatomical basis for reappraisal of carnivore evolution. J Morphol 143:21–75

    Article  Google Scholar 

  19. Hyrtl J (1845) Vergleichend-anatomische Untersuchungen über das innere Gehörorgan des Menschen und der Säugethiere. F. Ehrlich, Prag

    Google Scholar 

  20. Hyrtl J (1836) Neue beobachtungen aus dem gebiete der menschlichen und vergleichenden anatomie. Medizinische Jahrbucher oesterreich states 10:457–466

    Google Scholar 

  21. Kwok KY, Lo SSM, Tsang TK, Fan TW, Kwan TL (2010) Persistent stapedial artery: computed tomography and magnetic resonance imaging features. J HK Coll Radiol 12:139–142

    Google Scholar 

  22. Lefournier V, Vasdev A, Bessou P, Boubagra K (1999) A persistent pharyngohyostapedial artery: embryologic implications. AJNR Am J Neuroradiol 20:271–274

    PubMed  CAS  Google Scholar 

  23. Lewin L (1906) Das Vorkommen von Persistenz der A. Stapedia beim Menschen und die vergleichend anatomische und entwicklungsgeschichtliche Bedeutung dieses Phänomens. Arch f Ohrenlieilk 70:28

    Article  Google Scholar 

  24. Marion M, Hinojosa R, Khan AA (1985) Persistence of the stapedial artery: a histopathologic study. Otolaryngol Head Neck Surg 93:298

    PubMed  CAS  Google Scholar 

  25. McEachen JC, Obrzut M, Bokhari SJ (2009) A rare combination of carotid artery congenital abnormalities: understanding the embryology and clinical associations. Emerg Radiol 16:411–414

    Article  PubMed  Google Scholar 

  26. Moreano EH, Paparella MM, Zelterman D, Goycoolea MV (1994) Prevalence of facial canal dehiscence and of persistent stapedial artery in the human middle ear: a report of 1000 temporal bones. Laryngoscope 104:309–320

    PubMed  CAS  Google Scholar 

  27. Moret J, Delvert JC, Bretonneau CH, Lasjaunias P (1982) Vascularization of the ear: normal-variations-glomus tumors. J Neuroradiol 9:209–260

    PubMed  CAS  Google Scholar 

  28. Murphy MP, Seidman MD, Baugh RF (1995) Can a persistent stapedial artery be safely and effectively removed? A case report with therapeutic implications. Int Tinnitus J 1:147–152

    PubMed  Google Scholar 

  29. Nikolova SY, Toneva DH, Yordanov YA, Lazarov NE (2012) Absence of foramen spinosum and abnormal middle meningeal artery in cranial series. Anthropol Anz 69:351–366

    Article  PubMed  Google Scholar 

  30. Padget DH (1948) The development of the cranial arteries in the human embryo. Am J Anat 32:205–261

    Google Scholar 

  31. Perrier E (1932) Traité de Zoologie. Masson, Paris

    Google Scholar 

  32. Rodesch G, Choi IS, Lasjaunias P (1991) Complete persistence of the hyoido-stapedial artery in man. Surg Radiol Anat 13:63–65

    Article  PubMed  CAS  Google Scholar 

  33. Rodríguez-Vázquez JF (2005) Development of the stapes and associated structures in human embryos. J Anat 207:165–173

    Article  PubMed  Google Scholar 

  34. Sénécail B, Meriot P, Letourmy JM, Forlodou P, Nonent M (2004) Persistence of the stapedial artery: three cases. Morphologie 88:139–144

    Article  PubMed  Google Scholar 

  35. Silbergleit R, Quint DJ, Mehta BA, Patel SC, Metes JJ, Noujaim SE (2000) The persistent stapedial artery. AJNR Am J Neuroradiol 21:572–577

    PubMed  CAS  Google Scholar 

  36. Steffen TN (1968) Vascular anomalies of the middle ear. Laryngoscope 78(2):171–197

    Article  PubMed  CAS  Google Scholar 

  37. Wible JR (2008) The eutherian stapedial artery: character analysis and implications for superordinal relationships. Zool J Linn Soc 91:107–135

    Article  Google Scholar 

  38. Yilmaz T, Bilgen C, Savas R, Alper H (2003) Persistent stapedial artery: MR angiographic and CT findings. AJNR Am J Neuroradiol 24:1133–1135

    PubMed  Google Scholar 

  39. Zuckerkandl E (1873) Uber die Arteria stapedia des Menschen. Monatsschr f Ohrenheilkunde 7:5–7

    Google Scholar 

Download references

Acknowledgments

We thank Pr Paul F. Smith, from the University of Otago School of Medical Sciences, for his revision of the English language of this article.

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Martin Hitier.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hitier, M., Zhang, M., Labrousse, M. et al. Persistent stapedial arteries in human: from phylogeny to surgical consequences. Surg Radiol Anat 35, 883–891 (2013). https://doi.org/10.1007/s00276-013-1127-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-013-1127-z

Keywords

Navigation