Transient Perivascular Inflammation of Carotid Artery (TIPIC) Syndrome in Otolaryngology

Introduction: TIPIC Syndrome (TS, Transient Perivascular Inflammation of the Carotid artery) around carotid bifurcation previously referred as carotidynia is a syndrome of unknown entity lasting 2 weeks or less with tenderness, swelling, increased pulsations particularly over the carotid bifurcation. Radiologic confirmation can be with CT, MRI and US with resolution of symptoms with anti-inflammatory medications. While the otolaryngologist is the specialist usually consulted, TS is absent from the ENT literature and therefore from the differential diagnosis. Herein presented a series of patients with TS.

Methods: A chart review of patients with TS was possible only after reviewing records of neuroradiological diagnosis in a single institution from 2012 - 2022, as a specific ICD 10 code does not exist. Demographics, presenting symptoms, treatment and outcomes were reviewed.

Results: Five patients were identified. Final diagnosis was made by clinical presentation with typical radiological confirmation. CT neck with contrast only (2 patients), MRI with Gadolinium only (2 patients) and 1 patient had both CT and MRI. Four females and one male identified (age range 30- 42). The radiologic image was 3/5 soft plaque and 2/5 perivascular inflammation with small perivascular nodes. None had an autoimmune background and symptoms resolved following 2 weeks of NSAIDs and/or steroids.

Conclusions: TIPIC syndrome represents a better diagnosis to a formerly suspected conditioned by way of applying the correct tools of imaging to a clinical diagnosis. Acute neck pain deserves a better diagnosis by carefully selecting necessary imaging modality. The treatment is anti-inflammatory with typical resolution. The resemblances to a soft plaque should raise further research whether those patient merit future treatment with statins.