[Aberrant intra-petrous internal carotid artery: apropos of a case]

This article illustrates a case of an aberrant pathway of the petrous portion of an internal carotid artery presenting as a cholesteatoma. This is a case of a 53 y.o man presenting with unilateral otalgia and vertigo. Otoscopic examination revealed a whitish retro-tympanic mass accompanied by a conduction hearing loss mimicking a cholesteatoma. An exploratory tympanotomy was performed. The surgical procedure was interrupted after needle aspiration of the mass suggesting an aberrant course of the petrous portion of the internal carotid artery. Authors report a review of the literature with an emphasis on the differential diagnosis, clinical and paraclinical diagnostic work-up. A thorough knowledge of this anomaly is required to avoid an iatrogenic risk during any otological surgery.