Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 5
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Deep, Aman Mortazavi, Martin M. and Adeeb, Nimer 2016. Bergman's Comprehensive Encyclopedia of Human Anatomic Variation.

    Thomassin, J.-M. Rossi, M.E. and Reyre, A. 2016. Acúfenos objetivos. EMC - Otorrinolaringología, Vol. 45, Issue. 2, p. 1.

    Thomassin, J.-M. Rossi, M.E. and Reyre, A. 2016. Acufeni oggettivi. EMC - Otorinolaringoiatria, Vol. 15, Issue. 2, p. 1.

    Blazic, Srbislav Milojevic, Milanko Grgurevic, Ugljesa and Djeric, Dragoslava 2015. Anatomical variations and relations of large blood vessels to the tympanic cavity. Surgical and Radiologic Anatomy, Vol. 37, Issue. 4, p. 327.

    Rangel-Castilla, Leonardo McDougall, Cameron G. Spetzler, Robert F. and Nakaji, Peter 2014. Urgent Cerebral Revascularization Bypass Surgery for Iatrogenic Skull Base Internal Carotid Artery Injury. Neurosurgery, Vol. 10, p. 640.


Aberrant internal carotid artery in the middle ear with dehiscent high jugular bulb

  • Y-Y Lin (a1), C-H Wang (a1), S-C Liu (a1) and H-C Chen (a1)
  • DOI:
  • Published online: 19 April 2012

We report an extremely rare case of an aberrant internal carotid artery in the middle ear, together with a dehiscent high jugular bulb, a combination never previously reported.


Case report with a review of the literature.


A 24-year-old man presented with a five-year history of aural fullness, pulsatile tinnitus and mild hearing impairment in his right ear. Otoscopy revealed a retro-tympanic mass. Computed tomography of the temporal bone revealed protrusion of the right internal carotid artery into the middle-ear cavity, with a dehiscent high jugular bulb. Magnetic resonance angiography showed a reduced diameter and lateralisation of the right internal carotid artery. A diagnosis of an aberrant internal carotid artery with a dehiscent high jugular bulb was made, and the patient was managed with conservative treatment.


The otologist should be aware of the possibility of an aberrant internal carotid artery when the patient presents with a retro-tympanic mass, hearing loss and pulsatile tinnitus. Radiological investigation is required to make the differential diagnosis. When an aberrant internal carotid artery presents with a dehiscent high jugular bulb, the risk of serious bleeding is elevated. We recommend a conservative approach for cases presenting without bleeding complications.

Corresponding author
Address for correspondence: Dr Hsin-Chien Chen, Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, 325, Sec 2, Cheng-Kung Rd, Taipei 114, Taiwan, ROC Fax: 886 2 87927193 E-mail:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

3M Botma , RA Kell , J Bhattacharya , JA Crowther . Aberrant internal carotid artery in the middle-ear space. J Laryngol Otol 2000;114:784–7

4E Sauvaget , J Paris , S Kici , R Kania , JP Guichard , R Chapot Aberrant internal carotid artery in the temporal bone: imaging findings and management. Arch Otolaryngol Head Neck Surg 2006;132:8691

5S Koesling , P Kunkel , T Schul . Vascular anomalies, sutures and small canals of the temporal bone on axial CT. Eur J Radiol 2005;54:335–43

6CH Wang , ZP Shi , DW Liu , HW Wang , BR Huang , HC Chen . High computed tomographic correlations between carotid canal dehiscence and high jugular bulb in the middle ear. Audiol Neurootol 2011;16:106–12

7RL Ruggles , RC Reed . Treatment of aberrant carotid arteries in the middle ear: a report of two cases. Laryngoscope 1972;82:1199–205

8BR Huang , CH Wang , YH Young . Dehiscent high jugular bulb: a pitfall in middle ear surgery. Otol Neurotol 2006;27:923–7

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *