IJAR.2017.228
Type of Article: Original Research
Volume 5; Issue 2.3 (June 2017)
Page No.: 3958-3963
DOI: https://dx.doi.org/10.16965/ijar.2017.228
CLINICAL IMPLICATIONS OF VARIABLE ORIGIN OF EXTERNAL CAROTID ARTERY BRANCHES AND HIGH LEVEL BIFURCATION OF COMMON CAROTID ARTERY
Esakkiammal. N1*, Renu Chauhan 2 , Rakhee Sharma 3.
*1 Senior Demonstrator, Department of Anatomy, University College of Medical Sciences, Delhi, India.
2 Professor & HOD, Department of Anatomy, University College of Medical Sciences, Delhi, India.
3 Senior Demonstrator, Department of Anatomy, University College of Medical Sciences, Delhi, India.
Address for Correspondence: Esakkiammal. N, Senior Demonstrator, Department of Anatomy, UCMS & GTB Hospital, Dilshad Garden, Delhi: 110095. Mobile: 91 – 9650525642. E-Mail: esakki510@gmail.com
ABSTRACT:
Background: The common, internal and external carotid arteries are the major source of blood supply to the region of head and neck. The anatomy of the carotid arteries is of special interest to surgeons involved in the management of head and neck pathology. The presence of any anomalous origin and or course of these vessels is usually discovered as an incidental finding when imaging studies are performed during investigations of relevant clinical conditions.
Materials and Methods: The present study was conducted in the department of anatomy, University College of Medical Sciences (UCMS), Delhi, India. Twenty six formalin fixed head and neck regions belonging to either sex were dissected on both the sides. The level of common carotid artery (CCA) bifurcation and any variation from the normal in the branching pattern of external carotid artery (ECA) were noted and photographed.
Results: Out of twenty six head and neck regions studied (52 sides), variations in the level of bifurcation of CCA and branches of ECA were observed. In the present study, in 9 hemi sections of head and neck (Right=5: Left=4), CCA bifurcated above the normal level near to the angle of mandible. On the left side, in 7 specimens lingual and facial artery arose as a common trunk i.e linguo-facial trunk from ECA. In 3 specimens on the left side, superior thyroid artery (STA) arose from the CCA. Superior thyroid artery arose at the level of carotid bifurcation (CB) in 14 specimens (right = 8, left = 6).
Conclusion: The present study reports high bifurcation of CCA and variations in the origin of some of the branches of ECA. These findings may be utilised by vascular surgeons operating in the region of head and neck for preventing accidental injury to these vessels.
Key words: Carotid bifurcation, External carotid artery, Linguo-facial trunk, Superior thyroid artery.
REFERENCES
- Standring S. Gray’s Anatomy. The Anatomical basis of clinical practice. 40thEd, Edinburg, Elsevier Churchill Livingstone, 2008; pp 435-52.
- Mehta V, Suri RK, Arora J, Rath G, Das S. Anomalous superior thyroid artery. Kathmandu Univ Med J (KUMJ), 2010;8(32):429-31.
- Morrigyl B, Sturm W. Absence of three regular thyroid arteries replaced by an unusual lowest thyroid artery: A case report. Surg Radiol Anat, 1996;18:147-50.
- Vandana Mehta, Rajesh.K.Suri, Jyoti Arora, Gayatri Rath, Srijit Das. Anomalous (absent) Superior Thyroid Artery. Kathmandu Univ Med J, 2010;8(32):426-8.
- Shivaleela C, Anupama D, Lakshmi Prabha Subhash R Study of anatomical variations in the origin of superior thyroid artery. Int J Anat Res, 2016;4(1):1765-1768.
- Williams PL, Bannister LH, Berry MM. Gray’s Anatomy. Arteries of limbs and cardiovascular system. 38th ed, London, Churchill Livingston, 1995;pp 1516-17.
- Bergman RA, Afifi AK, Miyauchi R. Illustrated Encyclopedia of Human Anatomic Variation: Cardiovascular system: Arteries: Head, Neck and Thorax.Common carotid arteries. http://www.anatomyatlases.org/AnatomicVariants/Cardiovascular/ Text/Arteries/ Carotid Common.shtml (accessed on 7th may 2013).
- Fred MB. Post-tonsillectomy lingual artery pseudoaneurysm. www.triomeetingposters.org/wpcontent/uploads/2012/12/001.pdf (accessed on 21th july 2013).
- Kishve PS, Kishve SP, Joshi M, Aarif SM, Kalakoti P. An unusual branching pattern of common and external carotid artery in a human cadaver. Australian Medical Journal, 2011;4 (4):180-182.
- Gluncic V, Petanjek Z, Marusic A, Gluncic I. High bifurcation of common carotid artery, anomalous origin of ascending pharyngeal artery and anomalous branching pattern of external carotid artery. Surg Radiol Anat, 2001;23:123-5.
- Thwin SS, Soe MM, Myint M, Than M, Lwin S. Variations of the origin and branches of external carotid artery in human cadaver. Singapore Med J, 2010;51(2):40-42.
- Mahendrakar MA. Variations in the branching pattern of external carotid artery – a case report. J. Anat. Soc India, 2007;56:47-51.
- Al-Rafiah A, El-Haggagy AA, Aal IHA, Zaki AI. Anatomical study of the carotid bifurcation and origin variations of the ascending pharyngeal and superior thyroid arteries. Folia Morphologica , 2011;70(1):47–55.
- Lucev N, Bobinac D, Maric I, Drescik I. Variations of the great arteries in the carotid triangle. Otolaryngol Head Neck Surg, 2000;122:590-1.
- McNamara JR, Fulton GJ, Manning BJ. Three-dimensional computed tomographic reconstruction of the carotid artery; identifying high bifurcation. European Journal of Vascular and Endovascular Surgery, 2015;49(2):147–153.
- Gurbuz J, Çavdar S, Ozdogmu O. Trifurcation of the left common carotid artery; A case report. Clin Anat, 2001;14:58-61.
- Kozielac T Joswa TT. Variation in the course of facial artery in the prenatal in man. Folio Morphol (warsz), 1977;36:55-61.
- Anil A, Turgut Hb, Peker T, Pelin C. Variations of the branches of the external carotid artery. Gazi Med J, 2000;11(2):81-83.
- Gupta V, Agarwal R. Anomalous Branching Pattern of the External Carotid Artery in Cadavers. Int J Sci Stud, 2014;2 (1):28-31.
- Yildrin M, Tanyeli E, Solyluoglu AI, Tuna Y. Truncus linguofacialis siklig. Morfoloji Der, 2001;9(1):33-4.
- Lappas DA, Kamberos SP, Gisakis JG, Takis CH, Lykaki G. Anatomic study of the variations in the origin of the branches of the external carotid artery. Beta Medical Arts, 2002:81.
- Sanjeev IK, Anitha H, Ashwini M et al. Branching Pattern of external carotid artery in human cadavers. J Clin Diagnost Res, 2010;4:3128-33.
- Hollinshead WH. Anatomy for Surgeons; Head and Neck. Philadelphia, JB Lippincott, 1982.
- Arey LB. Developmental Anatomy: A Textbook and Laboratory Manual of Embryology. Philadelphia, WB Saunders,1965.