Rare anatomical variant of the cervical internal carotid artery

Agrawal, Gunjan; Gupta, Ashutosh; Chaudhary, Vivek; Mazhar, H.; Tiwari, Santanu

doi:10.1016/j.bjoms.2017.01.011

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…Aberrant curvatures of the extracranial ICA have been reported, but their clinical effect is underestimated 3 . Coiling and kinking comprise 6% and 5% of such variants, respectively 4 .…”

Section: Figmentioning

confidence: 99%

“…4 These cervical siphons are clinically silent in most cases and diagnosed incidentally by imaging or surgery. 3 As our patient underwent an ultrasound for neck imaging for early tongue cancer, we were unable to identify this preoperatively.…”

mentioning

confidence: 93%

“…Rest of the intra-and post-operative course was uneventful.Aberrant curvatures of the extracranial ICA have been reported, but their clinical effect is underestimated. 3 Coiling and kinking…”

mentioning

confidence: 99%

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Cervical carotid siphon: A potential menace during neck dissection

Kumar

Bhattacharya

2021

ANZ Journal of Surgery

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Variant configurations of the internal carotid artery (ICA), especially when curved in S-or C-shape, are often studied intracranially. 1 However, such abnormal siphons in the neck are less frequently explored for their clinical significance. 2 During neck dissection in cancer surgeries, this unexpected anatomy may predispose to devastating complications. We hereby discuss a case of an anomalous cervical ICA siphon impinging on the spinal accessory nerve (SAN) and its implication for the operating surgeon.A 52-year-old female patient with early tongue cancer underwent left wide excision glossectomy and selective neck dissection. While dissecting the SAN, we encountered a mass embedded in the lymphoadipose tissue in the Level II region. This appeared akin to a metastatic lymph node at the first glance. However, on palpation, the mass was found to be pulsatile and further dissection revealed it to be a tortuous ICA presenting as a curved siphon extending as laterally as the left SAN, coming to overly it (Fig. 1). Neck clearance, specifically of the Levels IIa and IIb, was done by careful blunt dissection and gently retracting the siphon with a thumb retractor avoiding undue pressure over the carotid. Meticulous hemostasis was secured at the end of the procedure. Rest of the intra-and post-operative course was uneventful.Aberrant curvatures of the extracranial ICA have been reported, but their clinical effect is underestimated. 3 Coiling and kinking

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“…Aberrant curvatures of the extracranial ICA have been reported, but their clinical effect is underestimated 3 . Coiling and kinking comprise 6% and 5% of such variants, respectively 4 .…”

Section: Figmentioning

confidence: 99%

mentioning

confidence: 93%

See 1 more Smart Citation

Cervical carotid siphon: A potential menace during neck dissection

Kumar

Bhattacharya

2021

ANZ Journal of Surgery

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Coiling of internal carotid through ‘eye of the needle’ internal jugular vein: a dual great vessel anomaly

Iftikhar

Ikram

2021

annals

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A variation in the usual course of great vessels during neck dissection can predispose them to inadvertent iatrogenic injury, which can lead to massive bleeding. We present a case of a male patient with oral squamous cell carcinoma who underwent inferior maxillectomy and supra-omohyoid neck dissection. Lateral coiling of the extracranial internal carotid artery was seen through fenestration of the internal jugular vein. Anomalies of great vessels in the neck are rare. Variation in the course of any of these vessels can prove to be catastrophic if control is not achieved. Careful study of radiographic imaging with special consideration given to the course of great vessels in the neck should be undertaken prior to neck surgeries.

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