What you see is what you hear: microangioscopy-guided management of carotid-cochlear dehiscence in pulsatile tinnitus

Angioscopy is an emerging technology in neurointervention.1-4 The Vena MicroAngioscope (MA) is a sterile, single-use, full-color, forward-viewing angioscope delivered through a guiding or distal access catheter, with or without flow arrest, and saline irrigation....

No actionable change for most audiologists — this is a rare surgical case report describing a novel device-guided intervention that falls outside routine audiology practice, but it may inform specialist referral decisions for pulsatile tinnitus of vascular origin.

This case introduces microangioscopy as a novel image-guided approach for a rare but debilitating vascular cause of pulsatile tinnitus, potentially expanding the diagnostic and interventional toolkit for neurointerventional teams.

1. 01Carotid-cochlear dehiscence (an abnormal opening between the carotid artery and cochlea/inner ear) caused pulsatile tinnitus in the described patient.
2. 02The Vena MicroAngioscope was used to visually guide the surgical intervention — a first-of-its-kind application in this context.
3. 03Published in the Journal of NeuroInterventional Surgery as a case report.
4. 04The technique provides direct visualisation (microangioscopy) to improve procedural precision.
5. 05Single case limits generalisability; further studies are needed.

PMID

42336642

DOI

10.1136/jnis-2026-025020.

Journal

Journal of NeuroInterventional Surgery

Publication type

case_report

Evidence level

4

Sample size

1

Population

Single patient with carotid-cochlear dehiscence and pulsatile tinnitus

Intervention

Microangioscopy-guided endovascular management using the Vena MicroAngioscope