A cadaveric study of morphology and morphometry of petrous and cavernous parts of the internal carotid artery (original) (raw)
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CLINICAL BASIS FOR THE KNOWLEDGE OF ANATOMY OF THE CAROTID ARTERY: A REVIEW ARTICLE
Yen Med J, 2020
The carotid artery is a major artery that supplies the head and neck region. Its internal carotid branch supplies the brain directly and serves as a major vessel of interest to neurosurgeons, while the external carotid branch mainly supplies structures in the neck, scalp and face. Whereas, diseases like atherosclerosis and aneurysm of the extracranial or intracranial parts respectively appear to affect the wall, they also have significant effect on luminal diameter and subsequent blood flow to the end organs like the brain. The aim of this review is to remind us of the importance of the anatomical knowledge of the vessel in clinical practice. Articles from google data base and standard texts of recent publication were reviewed. The physicians and surgeons managing patients with related conditions of the carotid artery and its branches will benefit from this review.
Neurologia medico-chirurgica, 2005
The nomenclature and borders of the segments of the internal carotid artery (ICA) remain confusing. A classification of segments of the ICA is proposed based on constant anatomical structures, such as the carotid foramen and canal, the petrous bone, the petrolingual ligament (PLL), and the proximal and distal dural rings. The bilateral ICAs were dissected in 15 cadaveric head specimens using different neurosurgical approaches. The bilateral lacerum foramina were studied in five dry skulls. The bilateral segments of the ICA were also examined on carotid angiograms of 10 normal patients and another with the ophthalmic artery originating from the intracavernous portion of the ICA. The present classification divides the ICA into five segments in the direction of the blood flow. The cervical segment is extradural and extracranial, the petrous segment is extradural and intraosseous, the cavernous segment is interdural and intracavernous, the clinoidal segment is interdural and paracavernous, and the cisternal segment is intradural and intracisternal. The ICA did not pass through the lacerum foramen in any specimen. In all specimens, 1/8 to 5/8 of the lacerum foramen was under the deep dural layer of the cavernous sinus. The term`lacerum segment' as used previously and called the`trigeminal segment' by us cannot be justified. The PLL is the posterolateral border of the cavernous sinus and the lacerum and trigeminal segments should be included in the cavernous and petrous segments. The ophthalmic artery may originate from the clinoidal ICA, from the cavernous ICA, or from the middle meningeal artery. Instead of using the term`ophthalmic segment,' the term`cisternal segment' should be used for the anatomically distinct ICA in the subarachnoid space. This classification should be minimally affected by anatomical variations.
Surgical and Radiologic Anatomy
Anatomical variations of the internal carotid artery (ICA) can cause complications during endovascular treatments. Therefore, the aim of this study was to investigate the features of the ICAs obtained from 2D digital subtraction angiography (2D DSA). Methods The morphometrics and angles of the ICA segments from 2D DSA images from a total of 100 patients (45 males and 55 females) were investigated. The lengths (L1-3), angles (A1-3), and diameters (D1-6) through the ICA measurement points (5 segments: C2 [petrous], C3 [lacerum], C4 [cavernous], C5 [clinoid], C6 (ophthalmic] were systemically recorded by two observers. All measured parameters were compared for both sexes and sides. Results The lengths (mm) and angles of the ICA were 7.20 ± 2.22 (L1), 15.71 ± 2.32 (L2), 10.99 ± 1.66 (L3) and 109.31 ± 17.77 (A1), 107.87 ± 20.51 (A2), 80.81 ± 16.33 (A3), respectively. There were no differences in the angulations of the A1-A3 segments between the sexes (p > 0.05). The L2 (C3-C4) was signi cantly longer in males, but only the left side of females showed a greater length (p < 0.05). The averaged mean diameters of the ICA (D1-6) in both sexes were 4.17 ± 0.55 mm. However, the diameters of the D1-D6 from left and right sides of males except the right D6 were signi cantly longer than those of females (p < 0.05). Also of signi cance was that the right diameters of females (D1) and males (D1 and D2) were shorter compared to left sides. Conclusion This study demonstrates some differences in lengths, diameters, and angles in both sexes and sides of the normal ICA. Neurosurgeons and neurointerventionalists should be aware of such variations when operating, performing interventional procedures, and interpreting 2D DSA.
Endoscopic anatomy of the petrous segment of the internal carotid artery
American Journal of Rhinology & Allergy, 2009
Background: Exposure of the petrous (C2) segment of the internal carotid artery (ICA; petrous carotid) is necessary to treat lesions that have spread from the intracranial space or adjacent sinonasal region. Recent advancements in endonasal-endoscopic approaches to the anterior skull base raise the possibility of extending these approaches beyond the sinonasal cavity. In this cadaveric study, we evaluate the feasibility and extent of exposure of the petrous carotid artery via a combined endoscopic endonasal approach. Methods: Endoscopic dissection was performed in four formalin-fixed cadaver heads (eight sides). An endoscopic, endonasal, transmaxillary approach was used to identify the cervical and petrous carotid artery. Results: With the endoscopic endonasal, Caldwell-Luc approach, we could visualize the ventral petrous bone after dissecting the contents of the pterygopalatine fossa and infratemporal fossa. Careful dissection allowed exposure of the petrous carotid artery from the upper cervical carotid to the foramen lacerum. Conclusion: In this cadaveric study using an endoscopic endonasal approach for exposure of the petrous carotid artery, combination with the transmaxillary-transpterygopalatine-transinfratemporal approaches permitted exposure of the ventral portion of the artery. The anatomy presented will assist experienced endoscopic skull base surgeons in the removal of lesions involving the ventral skull base.
Indian Journal of Clinical Anatomy and Physiology, 2021
Evaluation of carotid bifurcation level and relationship of External Carotid Artery (ECA) with reference to adjacent anatomical landmarks is important in planning various surgical and radiological procedures related to the carotid arteries. The aim was to study the relationship of External Carotid Artery with reference to Adjacent Anatomical landmarks in cadavers. 60 cadavers - 52 male and 8 female embalmed with 10% formalin were dissected over the period of two years for this study. The distance between the origin and the termination of ECA was found to be in the range of 25–70 mm on the right side and in the range of 25–68 mm on the left side. The distance between the origin of ECA and the carotid tubercle was found to be in the range of 23–50 mm on the right side and in the range of 22–48 mm on the left side. The distance between the origin of ECA and the angle of the mandible was found to be in the range of 18–30 mm on the right side and in the range of 20–32 mm on the left side...
A cross sectional study of variations in the external carotid artery in cadavers
The External Carotid Artery supplies mostly the scalp, neck and face regions of the body. A detailed knowledge of blood vessels and nerves in this head, neck and face regions is very helpful in various therapeutic and diagnostic procedures such as surgical resection of head, neck, face and oral cancers, radical neck dissection, plastic and reconstructive surgeries related to this vital region. Cerebrovascular strokes due to atherosclerosis, haemorrhage or embolism require radiological investigation like carotid angiogram, surgical procedures like carotid endarterectomy also require a thourough knowledge of anatomy of external carotid artery and its branches. Anomalous branching pattern of the carotid arteries and variations in the relative position of internal and external carotid arteries can also damage cranial nerves related to them. Hence, it was decided to undertake a morphometric study of external carotid artery by meticulous dissection of cadavers. The aim was to study variations in the course, relations and branching pattern of External Carotid Artery. In this study, 60 cadavers embalmed with 10% formalin were used, and thus 120 neck-halves were studied. Of these cadavers 52 were male and 8 were female. These cadavers were obtained from the Department of Anatomy, Seth G.S. Medical College, Parel, Mumbai, Maharashtra. The present study was conducted over the period of two years. Linguofacial trunk was observed to be the commonest variation i.e. in 17 cases (28.33%) on the right side and in 18 cases (30%) on the left side. Thyrolinguofacial trunk was encountered in one case (1.67%) on the left side. Also Accessory branches of ECA such as branches to the parotid gland, submandibulargland, infrahyoid region and pharyngeal muscular branches were found in 6 cases (10%) on the right side and in 5 cases (8.33%) on the left side.
Variations of the origin and branches of the external carotid artery in a human cadaver
Singapore medical journal, 2010
We report a unique variation in the origin and branches of both the left and right external carotid artery (ECA) found during the dissection of a human cadaver. Knowledge of the possible anatomical variations of the ECA is especially important in facio-maxillary and neck surgeries. Surgeons need to be aware of the possibility of encountering such variations, as they may lead to difficulties in differentiating between the external and internal carotid arteries, and in identifying the branches and origins. This knowledge is also important for radiologists in the image interpretation of the face and neck regions.
A cadaveric study on variations in branching pattern of external carotid artery
Anatomy & Cell Biology, 2018
Variations in the vascular anatomy of the carotid triangle have been reported in current scientific literature. The carotid arteries, being the major feeding arteries of the head and neck deserve special importance and protection from iatrogenic injury during radiological evaluations and surgical interventions. The present study was carried out over a period of 4 years from 2012-2016 to assess the variant anatomy of external carotid artery. The external carotid artery and its branches were dissected bilaterally in 40 formalin embalmed cadavers. The external carotid artery was traced from its origin to termination and variations in the branching pattern as well as the level of the carotid bifurcation were observed and analysed. A higher carotid bifurcation was observed in 25% cases. The linguofacial trunk was the commonest variation noted in the branching pattern seen in 20% cases. A single case of unilateral thyrolinguofacial trunk was also observed. The external carotid artery gave rise to accessory branches in 7.5% cases namely the superior laryngeal, accessory ascending pharyngeal and masseteric branches. A slender branch to the internal jugular vein was also observed in one case. These findings may provide further insight into the understanding of the vascular anatomy of the carotid triangle to the curious student, the discerning radiologist and the vigilant surgeon to avert complications and help improve overall treatment outcome.
Background & Aim: Anyone practising surgery or medicine should have a firm grasp on the regular anatomy of ECA and its variants, as well as its branches. Both carotid endarterectomy and carotid stenting, which are used to prevent recurrent strokes, necessitate in-depth familiarity with the carotid system. The aim of the present study was to study the relationship of External Carotid Artery with reference to Adjacent Anatomical landmarks in cadavers. Methods: The present prospective study was done in the Department of Anatomy, RMCRC, Rama University, Kanpur, UP, India, over a period of 1.5 years after obtaining clearance from the institutional ethical clearance committee. 30 hemi-necks obtained from 15 formalin embalmed cadavers (10 male and 5 female) were dissected and the external carotid arteries were traced from the origin to termination. Results: The ECA took origin at the level of upper border of thyroid cartilage (TC) in 20/30 cases (66.66%). Higher level of origin was noted in the remaining 10 of 30 cases (33.34%). Higher levels of carotid bifurcation were further categorized keeping the TC as anatomical landmark. No lower levels of origin were noted in this study. The anteromedial position of the ECA relative to the ICA at the level of the carotid bifurcation was noted in all the cases. Conclusion: The anatomical knowledge of relationship of External Carotid Artery with reference to adjacent anatomical landmarks is helpful for vascular surgeons to plan surgeries and prevent complications during various diagnostic and therapeutic procedures.
Dissection of the Common and External Carotid Artery
Cerebrovascular Diseases, 2006
extension of the neck. Another report [2] describes 54 patients with blunt and sharp carotid artery injuries but without mentioning dissections. In 20% of the patients, the ECA was affected, but the trauma included stab wounds and gunshot wounds. Campbell et al.