Petrous internal carotid artery aneurysm: A cause of chronic otitis.

BACKGROUND: Aneurysm of the petrous segment of the internal carotid artery (pICA) is a rare pathology presenting with extracranial and especially oto-rhinological symptoms that can be misleading and delay diagnosis. METHODS: We report the case of a giant pICA aneurysm compressing the Eustachian tube (ET), presenting with hearing loss due to chronic serous otitis. A PRISMA review of the literature was performed to find similar cases. In addition, relevant anatomical sources were screened. RESULTS: Five reports about 7 cases of middle-ear effusion caused by pICA aneurysm compressing the ET were identified. Median age at diagnosis was 18.5 years. After endovascular treatment, overall outcome was favorable, with no mortality, although outcome was sometimes impaired by neurological comorbidities and unclear prognosis of hearing-loss recovery. DISCUSSION: These reports, though rare, offer relevant insights into the poorly known regional anatomy of the pICA, in the borderland between neurosurgery and ENT. Within the petrous bone, the osseous separation between the ET and the pICA is narrow, when not dehiscent. This leads to a risk of any pathological process in either the pICA or the ET impinging on the other. CONCLUSION: Giant pICA aneurysm is a rare cause of hearing loss, due to compression of the ET, leading to chronic serous otitis. This co-dependency between pICA and ET should be kept in mind, as it underlines the necessity of multidisciplinary management and could facilitate earlier diagnosis and therapeutic management when facing atypical clinical situations.

Biomimetic Bilayered Scaffolds for Tissue Engineering: From Current Design Strategies to Medical Applications.

Tissue damage due to cancer, congenital anomalies, and injuries needs new efficient treatments that allow tissue regeneration. In this context, tissue engineering shows a great potential to restore the native architecture and function of damaged tissues, by combining cells with specific scaffolds. Scaffolds made of natural and/or synthetic polymers and sometimes ceramics play a key role in guiding cell growth and formation of the new tissues. Monolayered scaffolds, which consist of uniform material structure, are reported as not being sufficient to mimic complex biological environment of the tissues. Osteochondral, cutaneous, vascular, and many other tissues all have multilayered structures, therefore multilayered scaffolds seem more advantageous to regenerate these tissues. In this review, recent advances in bilayered scaffolds design applied to regeneration of vascular, bone, cartilage, skin, periodontal, urinary bladder, and tracheal tissues are focused on. After a short introduction on tissue anatomy, composition and fabrication techniques of bilayered scaffolds are explained. Then, experimental results obtained in vitro and in vivo are described, and their limitations are given. Finally, difficulties in scaling up production of bilayer scaffolds and reaching the stage of clinical studies are discussed when multiple scaffold components are used.