Aberrant internal carotid artery in the middle ear: the duplication variant. Issue 4 (20th April 2019)

• Record Type: Journal Article
• Authors: Anagiotos, Andreas; Kazantzi, Maria; Tapis, Marios
• Is Part Of: BMJ case reports. Volume 12:Issue 4(2019)
• Publication Date: 2019-04-20
• Subjects: otolaryngology/ent -- ear, nose and throat/otolaryngology; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2018-228865
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Vascular variants concerning the internal carotid artery (ICA) at the skull base level are rare. Correct workup and diagnosis in case of suspicion of such a variant are important as it mimics glomus tumours and could complicate myringotomy or middle ear surgery. We report a case of a 39-year-old woman presented with a 6-month history of right pulsatile tinnitus and aural fullness. Ear microscopy examination revealed a pale red pulsatile mass anterior to the umbo. Radiological assessment using CT and MRI/magnetic resonance angiography confirmed the diagnosis of an aberrant ICA. Interestingly, a duplication of the ICA was demonstrated, in which the enlarged inferior tympanic artery presented as the aberrant ICA, whereas a narrower collateral hypoplastic native ICA was also present. A conservative approach with regular follow-up appointments was recommended.