[Extracranial aneurysms of the internal carotid artery--an otorhinolaryngologic problem?].

The problem of high cervical internal carotid aneurysms is demonstrated in two patients. One patient presented with a massive intermittent bleeding in the nasopharynx, the second with a sudden paralysis of the cranial nerves 9-12. 2/3 of these extracranial internal carotid aneurysms are situated at the bifurcation of the common carotid artery and 1/3 are located proximal the skull base. These aneurysms can be "congenital" or traumatic in origin or may arise as a complication of otitis media or tonsillitis. Diagnosis should be established by arteriography. Even for asymptomatic aneurysms the present therapeutic concept consists of a multidisciplinary surgical approach with attempted vascular reconstruction, since spontaneous rupture may occur at any moment.