Objective: To describe the clinical and radiological features of the vascular anomaly, aberrant internal carotid artery (ICA) in the temporal bone.
Methodology: Case reports on two patients.
Results and conclusions: Aberrant ICA in the middle ear is a rare congenital abnormality usually identified on a computed tomographic scan before beginning middle ear surgery. Misdiagnosis may lead to serious surgical complications such as major bleeding, or even neurological deficit due to endovascular occlusion.