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Aberrant internal carotid artery in the middle ear: the duplication variant
  1. Andreas Anagiotos1,
  2. Maria Kazantzi1 and
  3. Marios Tapis2
  1. 1 ENT Department, Nicosia General Hospital, Nicosia, Cyprus
  2. 2 Nicosia Otolaryngology Center, Nicosia, Cyprus
  1. Correspondence to Dr Andreas Anagiotos, andreas.anagiotos{at}


Vascular variants concerning the internal carotid artery (ICA) at the skull base level are rare. Correct workup and diagnosis in case of suspicion of such a variant are important as it mimics glomus tumours and could complicate myringotomy or middle ear surgery. We report a case of a 39-year-old woman presented with a 6-month history of right pulsatile tinnitus and aural fullness. Ear microscopy examination revealed a pale red pulsatile mass anterior to the umbo. Radiological assessment using CT and MRI/magnetic resonance angiography confirmed the diagnosis of an aberrant ICA. Interestingly, a duplication of the ICA was demonstrated, in which the enlarged inferior tympanic artery presented as the aberrant ICA, whereas a narrower collateral hypoplastic native ICA was also present. A conservative approach with regular follow-up appointments was recommended.

  • otolaryngology/ent
  • ear, nose and throat/otolaryngology

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  • Contributors AA: conception and design of the work, acquisition of data, drafting and revising the work, final approval of the version submitted. MK: acquisition of data, interpretation of data, drafting the work and final approval of the version submitted. MT: conception and design of the work, interpretation of data, revising the work and final approval of the version submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.