(A838) Internal Carotid Artery Pseudoaneurysm Associated with Skull Base Osteomyelitis: A Case Report and Literature Review

Introduction: Pseudoaneurysm of the internal carotid artery (ICA) is a rare complication of head and neck infections. To date, literature on managing this disease associated with otologic infections has been limited to case reports. We present a case of a petrous internal carotid pseudoaneurysm secondary to skull base osteomyelitis and a literature review.

Methods: A literature review was conducted using PubMed with the search terms (ear infection) AND (carotid artery pseudoaneurysm). 166 studies met this search criteria and this was further narrowed by those written in the English language. 156 studies were reviewed by their abstracts resulting in 11 studies relevant to our case. The references from these studies were also reviewed yielding four additional unique case reports.

Results: We present a 56-year-old-female who developed a petrous internal carotid pseudoaneurysm secondary to skull base osteomyelitis. She presented with bloody otorrhea after a myringotomy and an MRI demonstrating left skull base osteomyelitis and a pseudoaneurysm in the left petrous internal carotid. She was treated with endovascular embolization and long-term IV antibiotics and antifungal medications. Of the 16 studies reviewed all but two studies report management of the ICA pseudoaneurysm with endovascular techniques.

Conclusions: Carotid pseudoaneurysm is a rare potentially life-threatening complication of an otologic infection. Our patient was successfully treated with endovascular embolization and long-term antimicrobials, in line with the existing literature.