Christoph Becker1, Gerd J Ridder2, Jens Pfeiffer2. 1. Department of Otorhinolaryngology - Head and Neck Surgery, University of Freiburg, Freiburg 79106, Germany. Electronic address: christoph.becker@uniklinik-freiburg.de. 2. Department of Otorhinolaryngology - Head and Neck Surgery, University of Freiburg, Freiburg 79106, Germany.
Abstract
OBJECTIVE: Variations in the course of the internal carotid artery are not rare and likely to be a congenital anomaly. The purpose of this study is to highlight the clinical impact of aberrant internal carotid arteries in children for surgical and interventional procedures in the head and neck. METHODS: Retrospective study of the vessel course in patients under the age of 18 years over a period of 4.5 years. Vessels were classified according to the anatomic classification by Weibel and Fields and related to a previously proposed clinicoradiological risk classification system. Clinical implications are pointed out. RESULTS: Nine patients with a total of 14 aberrations (4 tortuosities, 7 kinkings and 3 coilings) were included. All aberrations were incidental intraoperative or radiological findings; no patient suffered from distinct symptoms. The minimum distance to the pharyngeal wall ranged from 0.8 to 9.0 mm with a mean of 3.8 mm. Anatomic classification and clinical risk of injury did not correlate. CONCLUSIONS: Routine pharyngeal surgery and interventional procedures are usually performed without any preoperative imaging. However, variations in the course of the internal carotid artery may considerably increase the risk of vessel injury and should always be anticipated.
OBJECTIVE: Variations in the course of the internal carotid artery are not rare and likely to be a congenital anomaly. The purpose of this study is to highlight the clinical impact of aberrant internal carotid arteries in children for surgical and interventional procedures in the head and neck. METHODS: Retrospective study of the vessel course in patients under the age of 18 years over a period of 4.5 years. Vessels were classified according to the anatomic classification by Weibel and Fields and related to a previously proposed clinicoradiological risk classification system. Clinical implications are pointed out. RESULTS: Nine patients with a total of 14 aberrations (4 tortuosities, 7 kinkings and 3 coilings) were included. All aberrations were incidental intraoperative or radiological findings; no patient suffered from distinct symptoms. The minimum distance to the pharyngeal wall ranged from 0.8 to 9.0 mm with a mean of 3.8 mm. Anatomic classification and clinical risk of injury did not correlate. CONCLUSIONS: Routine pharyngeal surgery and interventional procedures are usually performed without any preoperative imaging. However, variations in the course of the internal carotid artery may considerably increase the risk of vessel injury and should always be anticipated.