RESUMO
BACKGROUND: Carotid artery abnormality in the middle ear is a rare clinical condition. Recognition of the problems related with this abnormality is important since it may mimic vascular tumors. Any intervention with incomplete evaluation can be fatal. CASE REPORT: A 23-year-old girl with carotid abnormality and sensorineural hearing loss, unsteadiness and tinnitus is presented. She was followed for 2 months elsewhere assuming that she had Meniere's disease and had previously received some medication for otitis media with effusion. CONCLUSION: Tomography and magnetic resonance imaging of the temporal bone are very helpful for visualization of an aberrant carotid in the middle ear. Radiological presentations are the reduced caliber of the aberrant carotid, an absence of cranial opening of carotid canal, tubular coursing along the medial wall of the middle ear in continuity with the horizontal carotid canal, dehiscence of the lateral carotid plate and enlargement of the tympanic canalicus.
RESUMO
OBJECTIVES/HYPOTHESIS: To illustrate that a truncus bicaroticus and an elongated truncus brachiocephalicus are underestimated anatomic variations; and to highlight the risk of injury of these vessel anomalies during routine surgical interventions. DATA SOURCE: Report of a woman with long-term ventilation who was planned for conventional surgical tracheostomy. Due to a strong pulsatile vessel crossing the cricoid cartilage, the procedure was stopped. Further diagnostics revealed anomalies of the supraaortic vessels, including a truncus bicaroticus. CONCLUSION: Anomalies of supraaortic vessels are not rare and injuries may cause severe bleeding; therefore, we recommend performing a preoperative ultrasound, particularly before starting dilatative tracheostomy.