Aberrant internal carotid artery in the middle ear

An aberrant internal carotid artery (ICA) in the middle ear space can present in 1% of the population. the clinical diagnosis can be difficult as most patients with this anomaly are either asymptomatic or have nonspecific clinical symptoms and signs. Moreover the diagnosis can easily be missed and only discovered when injurey occur to the ICA during middle ear surgey with resulting life-threatning complications. A knowledge of this anomaly and its differential diagnosis is of high importance to any practitioner dealing with otologic diseases and performing otologic surgeries. We report a 7-year-old girl with a right aberrant ICA presenting with hearing loss and review published studies concerning this disease entity presentation, diagnosis, and management.