Management of carotid artery hemorrhage in middle ear surgery.

Iatrogenic injury to the carotid artery as it traverses the middle ear in its normal anatomic position is a rare but potentially life-threatening event. Predisposing factors include a thin or dehiscent plate of bone, which normally protects the artery at the level of the eustachian tube, erosive middle ear disease, or previous trauma. Prevention and management of carotid artery injuries in the middle ear are discussed with an applicable case report.