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Clinical Problem Solving: Radiology
September 2004

Radiology Quiz Case 1—Diagnosis

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2004;130(9):1124. doi:10.1001/archotol.130.9.1124-a

An aberrant ICA of the middle ear is a rare congenital vascular anomaly, with about 50 cases reported in the literature.1,2 Most cases occur in women and are located in the right ear. Normally, the ICA enters the petrous bone via the carotid canal medial to the styloid process and ascends vertically and anteriorly to the tympanic cavity, where it is normally covered by a bony shell. It then bends anteriorly and medially, passing the eustachian tube inferiorly, and, after crossing the foramen lacerum, enters the cranial fossa.3 An aberrant course of the ICA is caused by defective embryogenetic development.