DOI QR코드

DOI QR Code

Tri-ramification of left external carotid artery associated with anatomical variation of its branches and aneurysm formation

  • Received : 2023.12.21
  • Accepted : 2024.01.19
  • Published : 2024.06.30

Abstract

Essential sources of arterial vascularisation in the head and neck region are the left and right common carotid arteries (CCA) and their branches. The left CCA (LCCA) originates from the arch of the aorta and the right CCA originates from the brachiocephalic trunk. In this case report, there was a bilateral higher division of CCA at the plane of the greater cornua of the hyoid bone, unilateral tri-ramification of the LCCA and the left external carotid artery (LECA), and the origin of the linguo-facial trunk and the pharyngo-occipital trunk from the LECA. An aneurysm formed in the distal part of LECA before its termination. In this case, we propose a novel categorization called the punnapatla classification for the anatomical variance branching forms of ECA. These kinds of variations are important to the surgeons, and anaesthetists, during the surgeries of the head and neck.

Keywords

Acknowledgement

We'd like to thank the cadaver's relatives for giving their relatives corpses for teaching and research. We would also like to recognize the efforts of anatomy laboratory attendees in maintaining the cadavers and the laboratory regularly.

References

  1. Standring S. Gray's anatomy: the anatomical basis of clinical practice. 41st ed. Elsevier; 2016.
  2. Shreevastava AK, Das RS, Maheshwari TP, Damodhar BK. Bilateral high trifurcation of the common carotid artery and variable emergence of the lower branches of the external carotid artery: a cadaveric case report. Cureus 2022;14:e27657.
  3. Fazan VP, da Silva JH, Borges CT, Ribeiro RA, Caetano AG, Filho OA. An anatomical study on the lingual-facial trunk. Surg Radiol Anat 2009;31:267-70. https://doi.org/10.1007/s00276-008-0439-x
  4. Ozgur Z, Govsa F, Ozgur T. Assessment of origin characteristics of the front branches of the external carotid artery. J Craniofac Surg 2008;19:1159-66. https://doi.org/10.1097/SCS.0b013e3180690252
  5. 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.
  6. Charles AS, Rabi S, Jain A, Rana PK. Origin and branching pattern of external carotid artery - a cadaveric study. Eur J Anat 2021;25:187-196.
  7. Hayashi N, Hori E, Ohtani Y, Ohtani O, Kuwayama N, Endo S. Surgical anatomy of the cervical carotid artery for carotid endarterectomy. Neurol Med Chir (Tokyo) 2005;45:25-9; discussion 30. https://doi.org/10.2176/nmc.45.25
  8. Vazquez T, Cobiella R, Maranillo E, Valderrama FJ, McHanwell S, Parkin I, Sanudo JR. Anatomical variations of the superior thyroid and superior laryngeal arteries. Head Neck 2009;31:1078-85. https://doi.org/10.1002/hed.21077
  9. Devadas D, Pillay M, Sukumaran TT. A cadaveric study on variations in branching pattern of external carotid artery. Anat Cell Biol 2018;51:225-31. https://doi.org/10.5115/acb.2018.51.4.225
  10. Balachandran S, Subrammaniyan R, Kumar A, Dharan L. Idiopathic multiple aneurysm of external carotid artery. J Family Med Prim Care 2014;3:164-5. https://doi.org/10.4103/2249-4863.137667