Jacob Sanderson1, Charles Swail1, Mario Gamez1, Robert Chalk2, Ramaswamy Sharma3, Arunabh Bhattacharya4,5. 1. University of the Incarnate Word School of Osteopathic Medicine, 7615 Kennedy Hill Drive, San Antonio, TX, 78235, USA. 2. Department of Clinical and Applied Science Education, University of the Incarnate Word School of Osteopathic Medicine, 7615 Kennedy Hill Drive, San Antonio, TX, 78235, USA. 3. Department of Cell Systems and Anatomy, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA. 4. Department of Clinical and Applied Science Education, University of the Incarnate Word School of Osteopathic Medicine, 7615 Kennedy Hill Drive, San Antonio, TX, 78235, USA. bhattach@uiwtx.edu. 5. Department of Cell Systems and Anatomy, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA. bhattach@uiwtx.edu.
Abstract
PURPOSE: Understanding the anatomical variations involving bifurcation of the common carotid artery, positioning of external and internal carotid arteries, and branching of the external carotid artery are of vital importance in neck surgeries such as carotid endarterectomies (CEA). METHODS: The neck of a 51-year-old female donor body was dissected to demonstrate the arterial network. RESULTS: Bifurcation of the common carotid artery occurred at the level of the C6-C7 intervertebral disc, significantly inferior to the generally accepted and taught anatomical location at the level of intervertebral disc between C3 and C4 vertebrae. When the arteries were followed superiorly after the bifurcation, a unique second variation was observed: translocation of the external and internal carotid arteries. The external carotid artery was located posterolaterally and the internal carotid artery was located more medially. Finally, a third variation was discovered in the form of a common thyrolingual trunk that gave rise to superior thyroid and lingual arteries rather than these arising independently from the external carotid artery. CONCLUSIONS: We report a unique triple variation within the major arteries of the neck that has not been previously reported in surveyed literature. This case report may provide useful information for cardiovascular surgeons performing CEA and for otolaryngologists performing prophylactic arterial ligation following transoral robotic surgery for oropharyngeal cancer resection.
PURPOSE: Understanding the anatomical variations involving bifurcation of the common carotid artery, positioning of external and internal carotid arteries, and branching of the external carotid artery are of vital importance in neck surgeries such as carotid endarterectomies (CEA). METHODS: The neck of a 51-year-old female donor body was dissected to demonstrate the arterial network. RESULTS: Bifurcation of the common carotid artery occurred at the level of the C6-C7 intervertebral disc, significantly inferior to the generally accepted and taught anatomical location at the level of intervertebral disc between C3 and C4 vertebrae. When the arteries were followed superiorly after the bifurcation, a unique second variation was observed: translocation of the external and internal carotid arteries. The external carotid artery was located posterolaterally and the internal carotid artery was located more medially. Finally, a third variation was discovered in the form of a common thyrolingual trunk that gave rise to superior thyroid and lingual arteries rather than these arising independently from the external carotid artery. CONCLUSIONS: We report a unique triple variation within the major arteries of the neck that has not been previously reported in surveyed literature. This case report may provide useful information for cardiovascular surgeons performing CEA and for otolaryngologists performing prophylactic arterial ligation following transoral robotic surgery for oropharyngeal cancer resection.