The mastoid emissary veins (MEVs) traverse the mastoid emissary canal (MEC) and connect the sigmoid sinus to the extracranial venous system. Although MEVs are frequently identified on angiography, an intraosseous arteriovenous fistula (AVF) arising primarily within the MEC has not been previously reported....
No actionable change for routine audiology practice — this single case report describes a rare surgical/neurointerventional procedure outside the audiologist's scope; awareness of pulsatile tinnitus as a red-flag symptom warranting vascular workup is already established.
Documents a rare but treatable vascular cause of pulsatile tinnitus, reinforcing the importance of appropriate referral pathways when patients present with pulse-synchronous ear sounds.
- 01Single case report of an intraosseous (within bone) arteriovenous fistula located in the mastoid emissary canal — an extremely rare vascular anomaly near the ear.
- 02Treated successfully with combined transvenous and transarterial embolization (blocking blood flow from two vessel routes simultaneously).
- 03Published in Journal of Neuroendovascular Therapy (2026).
- 04Pulsatile tinnitus is the hallmark presenting symptom of such vascular lesions.
- 05Case illustrates need for vascular imaging in patients with pulsatile, non-vibratory tinnitus.
Combined transvenous and transarterial embolization successfully treated an intraosseous arteriovenous fistula of the mastoid emissary canal.
studypartially supported- PMID
- 42266863
- DOI
- 10.5797/jnet.cr.2026-0006.
- Journal
- Journal of Neuroendovascular Therapy
- Publication type
- case_report
- Evidence level
- 4
- Sample size
- 1
- Population
- Single patient with intraosseous arteriovenous fistula of the mastoid emissary canal
- Intervention
- Combined transvenous and transarterial embolization
Primary outcomes
Technical success of embolization; Resolution of symptoms (pulsatile tinnitus)