Middle Ear Bleeding from Aneurysm in Aberrant Internal Carotid Artery

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We experienced right middle ear bleeding from an aneurysm in an aberrant internal carotid artery in a 68 year-old female. Her chief complaint was a slight right ear hemorrhage and mild hearing loss. She had a past history of cirrhosis and hepatocellular carcinoma, and was treated at the department of internal medicine in our hospital. On first examination, slight pulsation was observed in the inferior quadrant tympanic membrane of her right ear. High jugular bulb and glomus jugulare tumor were not revealed by computed tomography. Brain angiography was performed and the rupture of an aneurysm in an aberrant internal carotid artery in the middle ear was suspected as the cause. The observation was done because of the impaired liver function. However, transcatheter embolization was planned because of the massive successive bleeding episodes. Almost 100 percent embolization was obtained. After the operation, the aneurysm disappeared and there were no severe side effects except for slight sensorineural hearing loss. Pulsation of the tympanic membrane disappeared. Although it is a very rare disease, it is important as a cause of extensive bleeding from the middle ear.
耳鼻咽喉科臨床学会の論文