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Bruit caused by aberrant carotid artery in the middle ear
1Department of Surgery, Bowman Gray School of Medicine, Wake Forest University Medical Center, Winston-Salem, North Carolina 27103.
Insights
An aberrant internal carotid artery can course through the middle ear, mimicking a glomus jugulare tumor. This condition presents with ear pulsatile bruit and a tympanic membrane mass, necessitating careful diagnosis.
Area of Science:
- Vascular anatomy
- Otolaryngology
- Embryology
Background:
- The internal carotid artery (ICA) typically courses anterior to the middle ear.
- Developmental anomalies can alter the ICA's anatomical course.
Purpose of the Study:
- To describe the clinical presentation of an aberrant internal carotid artery coursing through the middle ear.
- To highlight the importance of differentiating this vascular anomaly from other middle ear pathologies, specifically glomus jugulare tumors.
Main Methods:
- Review of anatomical variations and embryological development of the internal carotid artery.
- Clinical case review focusing on symptoms, signs, and diagnostic imaging.
Main Results:
- An aberrant ICA may present as a pulsatile mass behind the tympanic membrane.
- Associated symptoms include pulsatile tinnitus or bruit.
- Distinguishing this from glomus tumors is crucial for appropriate management.
Conclusions:
- Aberrant internal carotid artery is a rare vascular anomaly that can present within the middle ear space.
- Clinical and radiological differentiation from glomus jugulare tumors is essential to avoid misdiagnosis and ensure correct treatment.
Abstract:
An aberrant course taken by the internal carotid artery during its development may lead it through, rather than anterior to, the middle ear space. The resulting symptoms and signs, including a pulsatile bruit in and around the ear and the presence of a mass behind the tympanic membrane, require differentiation from those of glomus jugulare tumor.