Aberrant Carotid Artery Injured at Myringotomy

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Abstract
THE NORMAL internal carotid artery enters the base of the skull through the carotid canal. The artery then bends medially and anteriorly, traversing the petrous bone and cavernous sinus, before emerging medial to the anterior clinoid process. As it passes through the bony petrous ridge, the artery is separated from the middle ear cavity by the tympanic plate. This 0.5-mm-thick plate may be disrupted in basilar skull fractures, displacing the carotid artery into the middle ear. The artery may also pass through the middle ear because of congenital anomalies in its course. Such a vessel may be seen through the tympanic membrane, where it may be mistaken for hemorrhage behind the drum or a tumor. The vessel may be injured during myringotomy; attempts to perform a biopsy of the "mass" may be disastrous. We recently treated a child who experienced massive hemorrhage from his ear after biopsy of such a

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