Aberrant internal carotid artery as a pulsatile mass in the posterior pharyngeal wall: a case report
Mohammad G. Raslan, Khaled Nasr, Waleed Said, Nawaf Fahad AlqhtaniBackground:
An aberrant cervical internal carotid artery rarely presents as a pulsatile submucosal mass closely related to the posterior pharyngeal wall. It can be completely asymptomatic or may sometimes manifest with tinnitus, dizziness, dysphagia, or sleep disorders. Most such patients have been documented in the literature as case reports.
Case report:
Here, we present the case of a 69-year-old man with a complaint of right-sided pulsatile tinnitus for more than 2 years. An ENT examination revealed submucosal pulsatile swelling on the right side of the posterior pharyngeal wall. A contrast-enhanced CT of the neck revealed high-grade kinking of the right internal carotid artery just underneath the mucosa of the pharyngeal wall. No medical or surgical intervention was performed. The condition was documented in the patient’s file to prevent future injury.
Conclusion:
Although uncommon, clinicians must consider the presence of aberrant internal carotid arteries in the neck, especially in elderly patients with a history of atherosclerosis who present with pulsatile tinnitus, dizziness, dysphagia, or sleep disorders. This anomaly carries a high risk of severe or fatal hemorrhage during neck surgery or endotracheal intubation and should be documented in the patient’s file.