[An aberrant course of the internal carotid artery through the middle ear].

The presence of the internal carotid artery in the middle ear is a rare but known vascular anomaly. A blue-reddish mass behind the tympanic membrane, hearing loss and a tinnitus that is synchronous with the pulse are the typical symptoms and should lead to a correct diagnosis. The diagnostic procedure includes high resolution CT scans with or without contrast or MRI. Possible methods of therapy include embolization, stent implantation or balloon occlusion of the internal carotid artery but are seldom indicated clinically because of the high rate of side-effects. However, regular followup examinations must be performed.