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Malformações vasculares na orelha média são raras, e a artéria carótida interna (ACI) aberrante deve ser lembrada no diagnóstico diferencial, visto o grande risco trazido por uma intervenção cirúrgica inadvertidamente realizada na cavidade timpânica. O paciente pode apresentar-se assintomático ou, comumente, com hipoacusia e/ou zumbido pulsátil. As imagens fornecidas pela tomografia computadorizada (TC) e ressonância magnética (RM), incluindo a angiorressonância, firmam o diagnóstico. Os autores descrevem um caso em criança de 13 anos, em que o diagnóstico foi feito através de exames de imagens, direcionados por uma importante suspeita clínica. Vascular anomalies of the middle ear are uncommon and, because aberrant internal carotid artery, among others, implies great risk at middle ear surgery, it must be remembered at the differential diagnosis. The patient may be asymptomatic, or complains of pulsatile tinnitus and conductive hearing loss. Computer tomography of the temporal bones and magnetic resonance imaging supplemented with magnetic resonance angiography can make the diagnosis. The authors present an aberrant internal carotid artery on a 13-year-old patient, whose diagnosis was performed by otoscopic examination, and imaging methods based on a previous clinical suspicion

Artéria carótida interna aberrante na orelha média