open access
Distance of the cervical part of the internal carotid artery from the selected anatomical structures in the parapharyngeal space and its relation to patient characteristics
Affiliations- Radiology Department, Greater Poland Cancer Centre, Poznan, Poland
- Department of Ophthalmology, University Clinical Hospital in Wroclaw, Poland
- Centre of Orthopaedics and Trauma Surgery, University Hospital Brandenburg, Brandenburg University of Medicine Theodor Fontane, Brandenburg an der Havel, Germany
- Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wroclaw, Poland
- Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland
- Division of Normal Anatomy, Department of Human Morphology and Embryology, Wroclaw Medical University, Wroclaw, Poland
- Department of Radiology, POLMED Diagnostyka, Legnica, Poland
open access
Abstract
Anomalies of the internal carotid artery (ICA) can increase the risk of haemorrhage during common surgical procedures. The aim of this literature review was to summarize the current state of knowledge on the course of the internal carotid artery in the parapharyngeal space, including the impact of the patient characteristics on the distances between the artery and other anatomical structures, as well as symptoms accompanying the aberrations. Pathologies related to the course of ICA in the parapharyngeal space are common (10%-60% in the general population and up to 84.4% in the elderly). In women, the distances in the oropharynx area are shorter than in men. Although the number of morphological studies is growing, providing more information on this topic, the identified studies differ in the methods and results. Knowledge on the variability in the course of ICA can help identify patients at high risk for the ICA trauma during pharyngeal procedures.
Abstract
Anomalies of the internal carotid artery (ICA) can increase the risk of haemorrhage during common surgical procedures. The aim of this literature review was to summarize the current state of knowledge on the course of the internal carotid artery in the parapharyngeal space, including the impact of the patient characteristics on the distances between the artery and other anatomical structures, as well as symptoms accompanying the aberrations. Pathologies related to the course of ICA in the parapharyngeal space are common (10%-60% in the general population and up to 84.4% in the elderly). In women, the distances in the oropharynx area are shorter than in men. Although the number of morphological studies is growing, providing more information on this topic, the identified studies differ in the methods and results. Knowledge on the variability in the course of ICA can help identify patients at high risk for the ICA trauma during pharyngeal procedures.
Keywords
internal carotid artery, tonsillectomy, haemorrhage, arterial aberrations, pharyngeal procedures, arterial anomalies, arterial trauma
About this articleTitle
Distance of the cervical part of the internal carotid artery from the selected anatomical structures in the parapharyngeal space and its relation to patient characteristics
Journal
Issue
Article type
Review article
Published online
2023-06-05
Page views
321
Article views/downloads
283
DOI
Pubmed
Keywords
internal carotid artery
tonsillectomy
haemorrhage
arterial aberrations
pharyngeal procedures
arterial anomalies
arterial trauma
Authors
Agnieszka Lis
Hanna Zając
Krzysztof Lachowski
Tomasz Zatoński
Anna Olchowy
Paweł Dąbrowski
Zygmunt Domagała
Cyprian Olchowy
References (44)- Agrawal R, Agrawal S. Dangerous anatomic variation of internal carotid artery — a rare case report. IJAV. 2011; 4.
- Arumugam S, Subbiah N. A cadaveric study on the course of the cervical segment of the internal carotid artery and its variations. Cureus. 2020.
- Beigelman R, Izaguirre AM, Robles M, et al. Are kinking and coiling of carotid artery congenital or acquired? Angiology. 2010; 61(1): 107–112.
- Benes V, Mohapl M. Alternative surgery for the kinked internal carotid artery. Acta Neurochir (Wien). 2001; 143(12): 1267–71; discussion 1271.
- Bergin M, Bird P, Cowan I, et al. Exploring the critical distance and position relationships between the eustachian tube and the internal carotid artery. Otol Neurotol. 2010; 31(9): 1511–1515.
- Bochenek A, Reicher M. Anatomia człowieka. Vol. III. PZWL, Warszawa 2012.
- Carvalho KS, Edwards-Brown M, Golomb M. Carotid dissection and stroke after tonsillectomy and adenoidectomy. Pediatr Neurol. 2007; 37(2): 127–129.
- Del Corso L, Moruzzo D, Conte B, et al. Tortuosity, kinking, and coiling of the carotid artery: expression of atherosclerosis or aging? Angiology. 1998; 49(5): 361–371.
- Deutsch MD, Kriss VM, Willging JP. Distance between the tonsillar fossa and internal carotid artery in children. Arch Otolaryngol Head Neck Surg. 1995; 121(12): 1410–1412.
- Devadas D, Pillay M, Sukumaran T. A cadaveric study on variations in branching pattern of external carotid artery. Anat Cell Biol. 2018; 51(4): 225.
- Ekici F, Tekbas G, Onder H, et al. Course anomalies of extracranial internal carotid artery and their relationship with pharyngeal wall: an evaluation with multislice CT. Surg Radiol Anat. 2012; 34(7): 625–631.
- Gabriel P, Mazoit X, Ecoffey C. Relationship between clinical history, coagulation tests, and perioperative bleeding during tonsillectomies in pediatrics. J Clin Anesth. 2000; 12(4): 288–291.
- Gaillard F, Sharma R, Rock P. Aberrant internal carotid artery. https://radiopaedia.org/articles/aberrant-internal-carotid-artery (20.12.2022).
- Galletti B, Bucolo S, Abbate G, et al. Internal carotid artery transposition as risk factor in pharyngeal surgery. Laryngoscope. 2009; 112(10): 1845–1848.
- Garrido MB, Jagtap R, Hansen M. Retropharyngeal internal carotid artery: a review of three cases. Oral Maxillofac Surg. 2020; 24(2): 255–261.
- Ghorbani M, Griessenauer C, Shojaei H, et al. Endovascular reconstruction of iatrogenic internal carotid artery injury following endonasal surgery: a systematic review. Neurosurg Rev. 2020; 44(4): 1797–1804.
- Gibber MJ. Tonsillectomy in adults: techniques and perioperative issues. UpToDate. https://www.uptodate.com/contents/tonsillectomy-in-adults (20.12.2022).
- Han HC. Twisted blood vessels: symptoms, etiology and biomechanical mechanisms. J Vasc Res. 2012; 49(3): 185–197.
- Hoffman HT, Hansen MR. A transnasal injection technique for the patulous eustachian tube. A presentation at the Combined Sections Meeting in Loews Resort, Miami Beach, 10-12 Jan 2014.
- Jackson JL. Tortuosity of the internal carotid artery and its relation to tonsillectomy. Can Med Assoc J. 1933; 29(5): 475–479.
- Jun BC, Jeon EJ, Kim DH, et al. Risk factors for decreased distance between internal carotid artery and pharyngeal wall. Auris Nasus Larynx. 2012; 39(6): 615–619.
- Brown Kelly A. Tortuosity of the internal carotid in relation to the pharynx. J Laryngol Otol. 2007; 40(1): 15–23.
- Koskas F, Bahnini A, Walden R, et al. Stenotic coiling and kinking of the internal carotid artery. Ann Vasc Surg. 1993; 7(6): 530–540.
- Krejza J, Arkuszewski M, Kasner S, et al. Carotid artery diameter in men and women and the relation to body and neck size. Stroke. 2006; 37(4): 1103–1105.
- Lien CF, Weng HH, Lin BS, et al. Effect of carotid artery aberrancy on the distance between the vessel and nasopharyngeal subsites. J Chin Med Assoc. 2014; 77(5): 253–257.
- Macchi C, Gulisano M, Gianelli F, et al. Kinking of the human internal carotid artery: a statistical study in 100 healthy subjects by echocolor Doppler. J Cardiovasc Surg (Torino). 1997; 38(6): 629–637.
- Muñoz A, Vergas J, Crespo J. Imaging and clinical findings in patients with aberrant course of the cervical internal carotid arteries. Open Neuroimag J. 2010; 4: 174–181.
- Myers EN, Snyderman CH. Operative otolaryngology: head and neck surgery, 3rd ed. Saunders, Philadelphia 2008.
- Ovchinnikov NA, Rao R, Rao S. Unilateral congenital elongation of the cervical part of the internal carotid artery with kinking and looping: two case reports and review of the literature. Head Face Med. 2007; 3: 29.
- Pancera P, Ribul M, Presciuttini B, et al. Prevalence of carotid artery kinking in 590 consecutive subjects evaluated by Echocolordoppler. Is there a correlation with arterial hypertension? J Intern Med. 2000; 248(1): 7–12.
- Paulsen F, Tillmann B, Christofides C, et al. Curving and looping of the internal carotid artery in relation to the pharynx: frequency, embryology and clinical implications. J Anat. 2002; 197(3): 373–381.
- Pfeiffer J, Ridder G. A clinical classification system for aberrant internal carotid arteries. Laryngoscope. 2009; 118(11): 1931–1936.
- Radak D, Babić S, Tanasković S, et al. Are the carotid kinking and coiling underestimated entities? Vojnosanit Pregl. 2012; 69(7): 616–619.
- Raffin CN, Montovani JC, Neto JMP, et al. Internal carotid artery pseudoaneurysm after tonsillectomy treated by endovascular approach. A case report. Interv Neuroradiol. 2002; 8(1): 71–75.
- Riechelmann H, Blassnigg EC, Profanter C, et al. No association between obesity and post-tonsillectomy haemorrhage. J Laryngol Otol. 2014; 128(5): 463–467.
- Shashikant K, Sherke A. tudy of internal carotid artery in human cadavers. Int J of Basic and Appl Med Sci. 2013; 3: 136–139.
- Sylvester P, Moran C, Derdeyn C, et al. Endovascular management of internal carotid artery injuries secondary to endonasal surgery: case series and review of the literature. J Neurosurg. 2016; 125(5): 1256–1276.
- Togay-Işikay C, Kim J, Betterman K. Carotid artery tortuosity, kinking, coiling: stroke risk factor, marker, or curiosity? Acta Neurol Belg. 2005; 105: 68–72.
- Weibel J, Fields WS. Tortuosity, coiling, and kinking of the internal carotid artery. I. Etiology and radiographic anatomy. Neurology. 1965; 15: 7–18.
- Windfuhr J, Schloendorff G, Sesterhenn A, et al. A devastating outcome after adenoidectomy and tonsillectomy: ideas for improved prevention and management. Otolaryngol Head Neck Surg. 2009; 140(2): 191–196.
- Wraige E, Ganesan V, Pohl KRE. Arterial dissection complicating tonsillectomy. Dev Med Child Neurol. 2003; 45(9): 638–639.
- Zając H, Lachowski K, Lis A, et al. The anatomical relation of the extracranial internal carotid arteryin the parapharyngeal space. Adv Clin Exp Med. 2019; 28(5): 601–607.
- Zenteno M, Viñuela F, Moscote-Salazar LR, et al. Clinical implications of internal carotid artery tortuosity, kinking and coiling: a systematic review. Rom Neurosurg. 2014; 21(1): 50–60.
- Zuckerkandl E. Zur Anatomie der Orbitalarterien. Medizinische Jahrbücher (Wien). 1876.
