An aberrant internal carotid artery passing through the middle ear is rare and may be misdiagnosed. Surgical intervention can lead to massive bleeding, possible hemiparesis, or both, as demonstrated by the following cases. The purpose of this article is to alert the otolaryngologist and the radiologist to the condition and to subtle computed tomographic features of an aberrant internal carotid artery. Recognition of these features should spare both surgeon and patient the consequences of ill-advised surgery.
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