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Microsurgical anatomy of the internal carotid artery at the skull base

Published online by Cambridge University Press:  02 November 2021

K C Prasad ,
A Gupta ,
G Induvarsha ,
P K Anjali  and
V Vyshnavi
K C Prasad
Affiliation:
Department of Otorhinolaryngology, Sri Devaraj Urs Medical College, Kolar, Karnataka, India
A Gupta*
Affiliation:
Department of Otorhinolaryngology, Sri Devaraj Urs Medical College, Kolar, Karnataka, India
G Induvarsha
Affiliation:
Department of Otorhinolaryngology, Sri Devaraj Urs Medical College, Kolar, Karnataka, India
P K Anjali
Affiliation:
Department of Otorhinolaryngology, Sri Devaraj Urs Medical College, Kolar, Karnataka, India
V Vyshnavi
Affiliation:
Department of Otorhinolaryngology, Sri Devaraj Urs Medical College, Kolar, Karnataka, India
*
Author for correspondence: Dr Arjun Gupta, Department of Otorhinolaryngology, Sri Devaraj Urs Medical College, Kolar, Karnataka, India E-mail: arjun8gupta@gmail.com
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Abstract

Background

The aetiology and significance of internal carotid artery variations at the skull base remain controversial after decades, with limited available literature. Approximately 10–40 per cent of the general population has parapharyngeal internal carotid artery variations.

Method

A prospective observational study was conducted on internal carotid artery variations in 36 cadavers, in a tertiary care hospital, between March 2019 to March 2020.

Results

The most common internal carotid artery variation observed in the specimens was tortuosity, in 30 per cent, followed by kinking in 18 per cent and coiling in 10 per cent. Thirty per cent of specimens had variations present bilaterally. A loop pattern of the internal carotid artery was identified. Coiling of the internal carotid artery may present as a node; hence, meticulous dissection is advocated near the skull base to avoid complications. These variations hold utmost importance for otorhinolaryngologists performing pharyngeal and nasopharyngeal surgical procedures.

Conclusion

A detailed knowledge of anatomy, along with its variations, and surgical expertise, will help reduce the incidence of surgical complications.

Keywords

Carotid Artery, InternalTortuositySkull Base
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 1 , January 2022 , pp. 64 - 67
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr A Gupta takes responsibility for the integrity of the content of the paper

References

Paulsen, F, Tillman, B, Christofides, C, Richter, W, Koebke, J. Curving and looping of the internal carotid artery in relation to the pharynx: frequency, embryology and clinical implications. J Anat 2000;197:373–81CrossRefGoogle Scholar
Pfeiffer, J, Ridder, GJ. A clinical classification system for aberrant internal carotid arteries. Laryngoscope 2008;118:1931–6CrossRefGoogle ScholarPubMed
Weibel, J, Fields, WS. Tortuosity, coiling, and kinking of the internal carotid artery. Etiology and radiographic anatomy. Neurology 1965;15:7–18CrossRefGoogle ScholarPubMed
Herrschaft, H. Abnormal tortuosity of the internal carotid artery and its clinical significance in surgery of the neck area [in German]. Z Laryngol Rhinol Otol 1969;48:85–98Google Scholar
Schenk, P, Temmel, A, Trattnig, S, Kainberger, F. Current aspects in diagnosis and therapy of carotid artery kinking [in German]. HNO 1996;44:178–85Google Scholar
Ozgur, Z, Celik, S, Govsa, F, Aktug, H, Ozgur, T. A study of the course of the internal carotid artery in the parapharyngeal space and its clinical importance. Eur Arch Otorhinolaryngol 2007;264:1483–9CrossRefGoogle ScholarPubMed
Ricciardelli, E, Hillel, AD, Schwartz, AN. Aberrant carotid artery - presentation in the near midline pharynx. Arch Otolaryngol Head Neck Surg 1989;115:519–22CrossRefGoogle ScholarPubMed
Metz, H, Murray-Leslie, RM, Bannister, RG, Bull, JW, Marshall, J. Kinking of the internal carotid artery. Lancet 1961;1:424–6CrossRefGoogle ScholarPubMed
Miller, S, Weill, A, Maillard, JC, Miaux, Y, Chiras, J. Aberrant internal carotid artery presenting in the midline retropharyngeal space: case report. Can Assoc Radiol J 1997;48:33–7Google ScholarPubMed
La Barbera, G, La Marca, G, Martino, A, Lo Verde, R, Valentino, F, Lipari, D et al. Kinking, coiling, and tortuosity of extracranial internal carotid artery: is it the effect of a metaplasia? Surg Radiol Anat 2006;28:573–80CrossRefGoogle ScholarPubMed
Iwasaki, S, Fujishiro, Y, Abbey, K. Glossopharyngeal neuralgia associated with aberrant internal carotid artery in the oropharynx. Ann Otol Rhinol Laryngol 2002;111:193–5CrossRefGoogle ScholarPubMed