Retropharyngeal course of the internal carotid artery

Régloix, S Ballivet de; Maurin, Olga

doi:10.1136/jramc-2017-000852

Cited by 6 publications

(3 citation statements)

References 1 publication

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“… 5 , 6 , 8 , 18 It is the most direct route from C1, and the direction of needle entry is safe for the vertebral artery, unless there are some patients with congenital variation of blood vessels. 19 However, the needle path has a medial to lateral direction, which is often not along the long axis of the lesion. Moreover, under fluoroscopic guidance, the skull will obviously block the field of vision.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Vertebroplasty for C1 Osteolytic Lesions via Lateral Approach Under Fluoroscopic Guidance

Yang

Tian

Wang

et al. 2021

JPR

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Objective: To report our experience of treating painful C1 osteolytic lesions with cement augmentation via a lateral approach under fluoroscopic guidance. Materials and Methods: Nine consecutive patients (eight men and one woman; mean age: 56.7±13.2 years) with osteolytic lesions of the atlas who underwent cementoplasty via a lateral approach were enrolled in this study. The technical success rate, operation time, and complications were recorded. Visual analogue scale (VAS) and Neck disability index (NDI) were used to evaluate the pain relief and neck function status pre-procedure (baseline) and post-procedure (at 3 days; after 1, 3, 6, 12, 18, and 24 months; and at the last follow-up). Results: The procedure was technically successful without any complications in all patients. The mean procedure time was 44.3±7.8 min. There were three cases of bone cement leakage, but no clinical symptoms. The mean VAS score decreased from 6.7±1.0 before the procedure to 3.7 three days after the procedure. The mean NDI score decreased from 67.3±11.2 before the procedure to 39.3±13.7 three days after the procedure. The VAS and NDI scores decreased at each follow-up time point, and the difference was statistically significant compared with the scores before the procedure (P<0.01). Conclusion: Fluoroscopy-guided lateral approach is a feasible, safe, and effective method for treatment of osteolytic lesions of the atlas and can relieve pain and stabilize the bone.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Vertebroplasty for C1 Osteolytic Lesions via Lateral Approach Under Fluoroscopic Guidance

Yang

Tian

Wang

et al. 2021

JPR

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“…The only risk of the transoral approach regarding vascular wounds is the possibility of a retropharyngeal course of the ICA. 21 Such variation of the cervical ICA course should thus be carefully studied on the pretreatment imaging work-up. We reported in our case series only one minor complication (6.7%), which consisted in a mild retropharyngeal hematoma that spontaneously resolved without any sequelae.…”

Section: Discussionmentioning

confidence: 99%

Transoral vertebroplasty for the C1 lateral mass

Clarençon

Shotar

Cormier

et al. 2020

J NeuroIntervent Surg

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BackgroundOsteolytic lesions of the atlas (C1) are challenging to treat by vertebroplasty due to the vicinity of the vertebral artery and the spinal cord.ObjectiveTo present our experience with transoral vertebroplasty (TOV) for osteolytic lesions of the lateral mass of the atlas.MethodsRetrospective case series involving 15 consecutive patients (nine male, six female, mean age 63 years) who underwent TOV for the treatment of an osteolytic lesion of the lateral mass of the atlas. Among the osteolytic lesions, 10/15 (67%) were bone metastases from various cancers; 4/15 (27%) were lesions related to multiple myeloma; and one lesion (7%) was an aggressive hemangioma. All the TOVs were performed under general anesthesia and in most cases (10/15; 67%) in a hybrid angiosuite combining a C-arm flat panel and a CT scan. The remaining five patients were treated under biplane fluoroscopic guidance.ResultsVertebroplasty of the lateral mass of C1 through a transoral route was feasible in all cases. Significant pain relief was obtained in most cases (1 month average decrease in Numeric Rating Scale: 4.9±4.1). No major complication was recorded. In 7/15 cases (47%), cement leakage surrounding the C1 lateral mass was seen; none of these leakages had a significant clinical consequence. No additional spine surgery was required in any of the patients.ConclusionTOV of osteolytic lesions of the lateral mass of the atlas is feasible and seems safe and effective, providing pain relief and bone stabilization.

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“…However, no direct correlation with anatomical variation and postoperative retropharyngeal hematoma have been identified. 12 - 15 The superior and inferior thyroid arteries have been identified as etiology of hemorrhage in some retrospective reviews of postoperative hematoma after ACDF, although most reported cases do not have an identifiable source of hemorrhage. 16 , 17 …”

Section: Discussionmentioning

confidence: 99%

Space-Occupying Lesions of the Retropharyngeal Space: An Anatomical Study With Application to Postoperative Retropharyngeal Hematomas

Glinski

Elia

Yılmaz

et al. 2020

Global Spine Journal

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Study Design: Cadaver study. Objective: The retropharyngeal space’s (RPS’s) clinical relevance is apparent in anterior cervical spine surgery with respect to postoperative hematoma, which can cause life-threatening airway obstruction. This cadaver study aims to establish guidance toward a better understanding of the tolerance of the RPS to accommodate fluid accumulation. Methods: Five fresh-frozen cadavers were dissected in the supine position. A digital manometer and a 20 Fr Foley catheter were inserted into the RPS via an anterolateral approach. While inflating the Foley catheter, the position of the esophagus/trachea was documented using fluoroscopy, and the retropharyngeal pressure was measured. We quantified the volume required to deviate the esophagus/trachea >1 cm from its original position using fluoroscopy. We also recorded the volume required to cause a visible change to the normal neck contour. Results: A mean volume of 12.5 mL (mean pressure 1.50 mm Hg) was needed to cause >1 cm of esophageal deviation. Tracheal deviation was encountered at a mean volume of 20.0 mL (mean pressure of 2.39 mm Hg). External visible clinical neck contour changes were apparent at a mean volume of 39 mL. Conclusion: A relatively small volume of fluid in the RPS can cause the esophagus/trachea to radiographically deviate. The esophagus is the structure in the RPS to be most influenced by mass effect. The mean volume of fluid required to cause clinically identifiable changes to the normal neck contour was nearly double the volume required to cause 1 cm of esophageal/tracheal deviation in a cadaver model.

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Retropharyngeal course of the internal carotid artery

Cited by 6 publications

References 1 publication

Percutaneous Vertebroplasty for C1 Osteolytic Lesions via Lateral Approach Under Fluoroscopic Guidance

Percutaneous Vertebroplasty for C1 Osteolytic Lesions via Lateral Approach Under Fluoroscopic Guidance

Transoral vertebroplasty for the C1 lateral mass

Space-Occupying Lesions of the Retropharyngeal Space: An Anatomical Study With Application to Postoperative Retropharyngeal Hematomas

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