An aberrant internal carotid artery (ICA) in the middle ear is known to occur in about 1% of the population, whereas duplicated ICA with a collateral hypoplastic native ICA is rather rarer. We report the case of a 41-year-old woman who presented with hearing loss and a feeling of pulsation of the tympanic membrane on the right side. Computed tomography revealed a middle ear mass and absence of the bone plate separating the ICA from the middle ear, continuity of the mass with the horizonal petrous portion of the ICA, and enlargement of the inferior tympanic canaliculus. The duplicated ICA was confirmed by angiography. It is important to diagnose an aberrant ICA, in view of the risk of hemorrhagic complicating tympanotomy or middle ear surgery.
