Otorrhagia in Chronic Otitis Media: An Unexpected Presentation of Internal Carotid Artery Rupture

Internal carotid artery rupture in the middle ear is very rare and can be life-threatening. We report the case of a 78-year-old male with a history of chronic otitis media who presented with spontaneous, high-volume otorrhagia. Computed tomography imaging revealed a dissection of the petrous segment of the internal carotid artery with an associated pseudoaneurysm. As the rupture of the pseudoaneurysm was considered the cause of otorrhagia, endovascular stenting was performed. After hospital admission for monitoring and antibiotic treatment, the patient underwent subtotal petrosectomy, with no further episodes of hemorrhage.