Localization of the Carotid Bifurcation According to Hyoid Bone and Mandibular Angle

Abstract

KURKCUOGLU, A.; PELIN, C.; OKTEM, H. & AYTEKIN, C.Localization of the carotid bifurcation according to hyoid bone and mandibular angle. Int. J. Morphol., 35(3):901-906, 2017. SUMMARY:The aim of this study was to determine the carotid bifurcation level in relation with the hyoid bone and mandibular angle. Common carotid artery is the largest artery in the neck, and it gives off two terminal branches, namely external and internal carotid arteries. The bifurcation level of it shows variations, however it is usually situated at the level of C4 vertebra or at the upper border of thyroid cartilage. On the other hand, carotid bifurcation may be situated as low as T3 vertebra, or as high as the level of hyoid bone. In this study, conventional angiographic images of 112 patients were used. The distances of carotid bifurcation to hyoid bone and mandibular angle were measured on those images. In addition, right and left side difference was determined. The distance of carotid bifurcation level to the mandibular angle was measured as 21.26 ± 8.57 mm on the right and 20.25 ± 8.75 mm on the left side in males, and 19.72 ± 8.89 on the right, and 18.5 ± 9.25 mm on the left side in females. Distance between the carotid bifurcation level and hyoid bone ranged 1.94 ± 12.69 mm in female and 3.04 ± 9.00 mm in male on the left side. Having information about the level of carotid bifurcation is important in surgical and radiological procedures for determining the appropriate surgical procedure, and to prevent complications. We believe that the results of this study will shed light to planning of all interventions concerning common carotid artery.

Is low carotid bifurcation determined by vertebral level always convenient for surgical approach?

“…The literature offers a spectrum of definitions; many studies have described HCB as a CB that resides higher than the body of the third cervical vertebra (C3) [2,[13][14][15]. Alternatively, some research recommends the superior border of the thyroid cartilage [8,[16][17][18], the lamina of the thyroid cartilage [19], the hyoid bone [8,[16][17][18]20], or a position within the first quartile of the HCB distribution within 5 cm of the mastoid process [17] as potential markers.…”