Open AccessAberrant internal carotid artery in the middle ear: the duplication variant
Author(s) -
Andreas Anagiotos,
Maria Kazantzi,
Marios Tapis
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-228865
Subject(s) - medicine , internal carotid artery , middle ear , radiology , magnetic resonance angiography , external carotid artery , magnetic resonance imaging , myringotomy , skull , surgery
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.