Fact-sheet: Aberrant intratympanic internal carotid artery


Updated on 08/26/2020 at 4:13 PM

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Definition

Course anomaly with an intratympanic segment of the internal carotid artery.

Association with anomalies such as persistence of the stapedial artery (with absence of the ipsilateral foramen spinosum in this case)

Predilection: women in their forties

Clinical features

  • Tinnitus
  • Asymptomatic

CT

  • Vascular soft-tissue structure in the tympanic cavity between the promontory and the eardrum.
  • Unusual opening in the floor of the tympanic cavity with absence of the carotid canal below and anterior to the promontory.
  • Opening close to the jugular bulb.
  • Often absent bony covering of the horizontal segment of the canal.
  • On bone window: enlargement of the inferior tympanic canaliculus

Management

Course anomaly that should be reported due to the risk of injury if otologic surgery is planned for another indication (paracentesis, or biopsy)

Differential diagnosis

  • Cholesteatoma
  • Glomus Paraganglioma
  • Aneurysm of the intrapetrous internal carotid artery
  • Cholesterol granuloma