Aberrant common and internal carotid arteries and their surgical implications: a case report

Bernardes, Marina Nahas Dafico; Cascudo, Natália Carasek Matos; Cheikh, Mikhael Romanholo El; Gonçalves, Victória Franco; Lamounier, Pauliana; Ramos, Hugo Valter Lisboa; Costa, Cleinaldo de Almeida

doi:10.1016/j.bjorl.2020.10.008

Cited by 2 publications

(4 citation statements)

References 8 publications

(10 reference statements)

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“…In types I–V, the CCA, BC, ECA, ICA, or both the ECA and ICA were found medially to the GHHB. These variants are of utmost importance during otorhinolaryngological surgeries such as tonsillectomy and drainage of peritonsillar abscesses, as well as during adenoidectomies and pharyngeal lesion biopsies [ 10 , 40 ]. Such anatomic variations should always be included in the differential diagnosis of pharyngeal wall bulging [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…These variants are of utmost importance during otorhinolaryngological surgeries such as tonsillectomy and drainage of peritonsillar abscesses, as well as during adenoidectomies and pharyngeal lesion biopsies [ 10 , 40 ]. Such anatomic variations should always be included in the differential diagnosis of pharyngeal wall bulging [ 40 ]. Specifically, surgeons should be aware that any carotid artery could be found medially to the GHHB, and as such posteriorly to the pyriform sinus (types I–V), which occurred in this study in 3.06% of individuals.…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, surgeons should be aware that any carotid artery could be found medially to the GHHB, and as such posteriorly to the pyriform sinus (types I–V), which occurred in this study in 3.06% of individuals. The inadvertent performance of biopsies or punctures nearing the pyriform sinus could lead to fatal outcomes, especially because the parapharyngeal space is a difficult region to evaluate clinically due to its location deep in the neck [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

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The Carotid–Hyoid Topography Is Variable

Manta,

Rusu,

Hostiuc

et al. 2023

Medicina

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Background and Objectives: The carotid bifurcation (CB) is presented in most anatomy textbooks as having a unique location at the upper margin of the thyroid cartilage. Although a number of case reports have provided evidence of the possibility of carotid artery location either lateral or medial to the greater hyoid horn, these reports have not established specific anatomic possibilities and prevalences. Materials and Methods: We retrospectively analysed a batch of 147 CT angiograms for 12 types of carotid–hyoid relationships and classified the bilateral combination possibilities of these types. Results: In 168/294 sides there were no carotid–hyoid relationships. Type I, external carotid artery (ECA) medial to the greater horn of the hyoid bone (GHHB), was observed in 0.34%; type II, internal carotid artery (ICA) medial to GHHB, in 0.34%; type III, ICA and ECA medial to GHHB, in 1.02%; type IV, common carotid artery (CCA) medial to GHHB, in 1.02%; type V, CB medial to GHHB, in 0.34%; type VI, ECA lateral to GHHB, in 20.41%; type VII, ICA lateral to GHHB, was not recorded; type VIII, ECA and ICA lateral to GHHB, in 3.74%; type IX, CCA lateral to GHHB, in 8.5%; type X, CB lateral to GHHB, in 6.46%; type XI, ECA lateral and ICA medial to GHHB, in 0.34%; and type XII, ICA lateral and ECA medial to GHHB, in 0.34%. Bilateral symmetry was found in 70.74% of cases, including the null types without carotid–hyoid relationships as well as types IV, VI, VIII, IX, and X. There was a highly significant association between the left and right variants of the carotid–hyoid relationship. Conclusions: Mechanical compression of the hyoid bone on the carotid arteries has various undesirable effects on the ICA and cerebral circulation. Underlying these are several variational anatomical patterns of carotid–hyoid relationships, which can be accurately documented on CT angiograms. A case-by-case anatomical study is better than assuming the carotid anatomy learned from textbooks.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Carotid–Hyoid Topography Is Variable

Manta,

Rusu,

Hostiuc

et al. 2023

Medicina

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“…Such histological characteristics provide protective effects against intimal thickening and smooth muscle penetrations, an important element for the prevention of atherosclerosis [21] Aberrant lateral branches of the ITA are rare anatomical and vascular variations that have received limited attention in the medical literature [22]. These variations have an incidence between 10% and 40% [23]. As such, aberrant right ITA can arise directly from the aorta and not from the subclavian artery [24].…”

Section: Introductionmentioning

confidence: 99%

A Rare Bilateral Variation in the Branches of the Internal Thoracic Artery: A Case Report

Hawi,

Jurjus,

Daouk

et al. 2023

Anatomia

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Background: Anatomical variations and, in particular, arterial variations constitute an important chapter in the learning of Clinical Anatomy. Purpose: The purpose of this report is to describe a rare bilateral anatomical variation in the internal thoracic artery (ITA) in a 60-year-old corpse and to depict its extreme clinical importance in coronary artery bypass surgery. Methods: The rare bilateral aberrant branches of the internal thoracic artery and their course in the thorax were incidentally discovered during routine anatomy dissection of the thorax at the Faculty of Medicine and Medical Sciences of the University of Balamand. The findings were thoroughly documented using digital photography, and the dissection followed the instructions from the “16th Edition of Grant’s Dissector”. Results: In the observed case, the left aberrant branch of ITA descends laterally and gives medial and lateral anterior intercostal branches at the first six intercostal spaces. Conversely, the right aberrant artery, which branches from the ITA, descends laterally and gives medial and lateral branches to every intercostal space in the first five intercostal spaces. Conclusion: This report emphasizes that any unexpected variations in the lateral aberrant branches of the internal thoracic artery may complicate the surgical procedure. Bilateral aberrant lateral branches of the internal thoracic artery constitute rare anatomical variations of the internal thoracic artery and have been rarely reported in the literature. Such a course for aberrant lateral branches in the thorax poses possible lethal complications during several procedures involving the thorax, including basic coronary artery bypass graft, thoracocentesis and intercostal paracentesis and breast reconstruction.

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Aberrant common and internal carotid arteries and their surgical implications: a case report

Cited by 2 publications

References 8 publications

The Carotid–Hyoid Topography Is Variable

The Carotid–Hyoid Topography Is Variable

A Rare Bilateral Variation in the Branches of the Internal Thoracic Artery: A Case Report

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