Aberrant Internal Carotid Artery: Presenting as a Mass in the Middle Ear

An aberrant internal carotid artery without aneurysm presenting in the middle ear as a mass was diagnosed preoperatively as a tumor of the glomus jugulare. An attempt at surgical removal was met with sudden, profuse hemorrhage. Definitive treatment of proximal ligation of the carotid and encasement of the involved portion of the vessel with muscle and fascia produced temporary aphasia and hemiparesis. The condition in the patient is believed to be bilateral due to bilateral physical findings preoperatively. The etiology is most likely congenital because of this fact as well as the presence of an associated anomaly of the carotid in the cervical area.