Ectopic internal carotid artery seen initially as middle ear tumor

Area of Science:

• Vascular anatomy
• Neurology
• Otology

Background:

• Ectopic carotid artery is a rare congenital anomaly.
• It can present with subtle neurological symptoms or severe deficits after middle ear surgery.
• Undiagnosed vascular middle ear masses pose a risk.

Observation:

• Neurological symptoms may be the initial presentation of an ectopic carotid artery.
• Transtympanic exploration of undiagnosed vascular masses can lead to severe neurological deficits.
• Angiography provides definitive diagnosis.

Findings:

• Ectopic carotid arteries are rare but carry significant risks.
• Delaying surgery until angiography excludes an ectopic carotid artery is advised.
• Injury during exploration of vascular middle ear masses can cause serious neurological damage.

Implications:

• Preoperative angiography is essential for vascular middle ear masses.
• This approach minimizes the risk of iatrogenic injury to aberrant carotid arteries.
• Improved patient safety in otologic surgery is paramount.