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Clinical Problem Solving: Radiology
June 20, 2011

Radiology Quiz Case 1: Diagnosis

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Arch Otolaryngol Head Neck Surg. 2011;137(6):631. doi:10.1001/archoto.2011.81-b

An atypical course of the internal carotid arteries (ICAs) can be found in approximately 5% of the population.1The ICAs often are encountered in the middle ear or in the retropharyngeal space. These locations put the arteries at risk during common surgical procedures. Most cases involving an atypical ICA are asymptomatic.2The discovery is usually an incidental finding on computed tomograms or magnetic resonance images. Periodically, a pulsatile mass will be preoperatively or intraoperatively identified in the oropharynx. Patients may complain of dysphagia or pharyngodynia if they are symptomatic.3

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