An aberrant course of the internal carotid artery through the middle ear

The presence of the internal carotid artery in the middle ear is a rare but known vascular anomaly. A blue-reddish mass behind the tympanic membrane, hearing loss and a tinnitus that is synchronous with the pulse are the typi cal symptoms and should lead to a correct diagnosis. The diagnostic procedu re includes high resolution CT scans with or without contrast or MRI. Possi ble methods of therapy include embolization, stent emplantation or ballon o cclusion of the internal carotid artery but are seldom indicated clinically because of the high rate of side-effects. However, regular followup examin ations must be performed.