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Table 3: 
Anatomic variations implicating the SA
Anatomic VariationsEmbryologic Implications
TypeIncidenceDirect and Indirect SignsEmbryologic ExplanationEmbryo Size (mm)
Complete persistence of the SA2 casesPetrous ICA origin of the MMA; petrous ICA origin of the internal maxillary artery; enlarged foramen spinosum; eroded cochlear promontoryLack of annexation of the maxillomandibular branch by the ventral pharyngeal artery; persistence of the tympanic segment of the SA24
Partial persistence of the SA0.4%Petrous ICA origin of the MMA; absent foramen spinosum; enlarged facial canalRegression of the proximal segment of the maxillomandibular branch; persistence of the tympanic segment of the SA24
Tympano-carotico-tympanic variant; aberrant flow of the ICA plus persistent SA5 casesIntratympanic course of the ICA; petrous ICA origin of the MMA; enlarged inferior tympanic canal; absent exocranial carotid canalRegression of the proximal segment of the maxillomandibular branch; persistence of the tympanic segment of the SA; agenesis of the first 2 segments of the ICA; anastomosis between inferior tympanic artery and caroticotympanic artery24; 4–5
Pharyngo-tympano-stapedial variant2 casesCervical ICA origin of the MMA; absent foramen spinosumRegression of the proximal segment of the maxillomandibular branch; persistence of the tympanic segment of the SA; anastomosis between the inferior tympanic artery and the caroticotympanic artery24
MMA origin of the OAn = 2%MMA origin of the OA; no OA from the ICA or only the central retinal arteryLack of annexation of the supraorbital branch by the OA; persistence of the sphenoidal part of the supraorbital branch24