A cadaveric study on variations in branching pattern of external carotid artery

Abstract

Variations in the vascular anatomy of the carotid triangle have been reported in current scientific literature. The carotid arteries, being the major feeding arteries of the head and neck deserve special importance and protection from iatrogenic injury during radiological evaluations and surgical interventions. The present study was carried out over a period of 4 years from 2012–2016 to assess the variant anatomy of external carotid artery. The external carotid artery and its branches were dissected bilaterally in 40 formalin embalmed cadavers. The external carotid artery was traced from its origin to termination and variations in the branching pattern as well as the level of the carotid bifurcation were observed and analysed. A higher carotid bifurcation was observed in 25% cases. The linguofacial trunk was the commonest variation noted in the branching pattern seen in 20% cases. A single case of unilateral thyrolinguofacial trunk was also observed. The external carotid artery gave rise to accessory branches in 7.5% cases namely the superior laryngeal, accessory ascending pharyngeal and masseteric branches. A slender branch to the internal jugular vein was also observed in one case. These findings may provide further insight into the understanding of the vascular anatomy of the carotid triangle to the curious student, the discerning radiologist and the vigilant surgeon to avert complications and help improve overall treatment outcome.

Do asians have higher carotid bifurcation? A computed tomographic angiogram study of the common carotid artery bifurcation and external carotid artery branching patterns

“…The distribution of branching patterns of carotid arteries in this study is quite different from other studies [Table 6]. [571011152728] The percentage of facial arteries that arose in common trunk with lingual arteries (linguofacial trunk) was more frequently found (29.2% vs. 0%–20%). The branching patterns of the occipital artery had the same distribution as the previous study.…”

“…Interestingly, even in the era of modern imaging techniques, most of the studies about the carotid bifurcation and the branching patterns were still performed in cadaveric specimens. [5678910111213141516] We believe that computed tomographic angiogram (CTA) of carotid can provide excellent visualization of anatomical variations and can be applied in clinical practice comparable to or even better than cadaveric data. Some studies used CTA or magnetic resonance angiography (MRA) of carotid as a method to determine the level of the carotid bifurcation.…”

Angiographic Characterization of the External Carotid Artery: Special Attention to Variations in Branching Patterns

“…Thus, the CCA usually bifurcates at the level of the C3 level. Recently, a higher level of origin was noted in 20 of 80 cadavers (25%) (Devadas et al 2018). They concluded that the higher level of the carotid bifurcation exhibited a great degree of anatomical variability.…”

“…After these branches, the ECA branches off into the posterior auricular artery (PAA), maxillary artery (MA), and superfi-cial temporal artery. Some common trunks, such as thyrolingual, linguofacial, thyrolinguofacial, occipitoascending pharyngeal, and occipitoauricular trunks, were also identified (Zümre et al 2005;Tanaka et al 2010;Devadas et al 2018).…”

Two cases of combined anatomical variations: maxillofacial trunk, vertebral, posterior communicating and anterior cerebral atresia, linguofacial and labiomental trunks

“…The linguofacial trunk is a well-known possibility of variation in which the LA and FA could emerge from the ECA [12]. The incidence of the linguofacial trunk has been reported being 7% [2], 7.5% [26], 10% [5], 18% [20], 20% [7,40], or 21% [24].…”