Pseudoaneurysm of petrous internal carotid artery presenting as aural polyp

Abstract

A 62-year-old male presented with a rare case of pseudoaneurysm of petrous internal carotid artery (ICA) caused by chronic otitis media manifesting as right aural polyp. There was massive bleeding following aural polypectomy and histopathology came as inflammatory polyp. HRCT temporal bone showed defect in petrous part of right ICA canal and features suggestive of cholesteatoma. CT angiogram showed a laterally directed aneurysm from the junction of horizontal and vertical segment of petrous ICA. Right ICA trapping done using coil embolization. Postcoiling angiogram showed nonopacification of aneurysm and good cross circulation from opposite side. After two months right modified radical mastoidectomy was done and intraoperative findings showed automastoidectomy with cholesteatoma filling mastoid and middle ear and erosion of ossicles. There was no postoperative complications and patient is now on regular follow-up and is asymptomatic. Psedoaneurysm of petrous ICA is rare and psedoaneurysm as a complication of chronic otitis media is extremely rare.