Carotid Artery-Cochlear Dehiscence Presenting With Pulsatile Tinnitus: A Case Report and Review of the Literature

Carotid artery-cochlear dehiscence (CCD) is an extremely rare clinical entity defined as the dehiscence of the bony partition between the cochlea and the internal carotid artery (ICA). This condition may present with pulsatile tinnitus, hearing loss, or vertigo, mimicking other otologic and skull base pathologies. Moreover, an unrecognized CCD may lead to ICA injury during otologic procedures, particularly cochlear implantation. Here, we report the case of a 20-year-old male who presented with a 3-year history of right-sided exertion-induced pulsatile tinnitus without other otologic symptoms. He was diagnosed with CCD on non-enhanced temporal bone CT. As the first CCD to be reported in Korea, this case highlights the importance of recognizing this rare condition and underscores the diagnostic value of temporal bone CT.