ANATOMICAL AND RADIOLOGICAL STUDY OF THE ARTERIES IN THE CAROTID TRIANGLE
Shawky M. Tayel1, Shadia A. Helmy2, Wafaa A. Ahmed1, Ayman A. Khanfour1, Miriam R. R. F. Abdelmalek1
Department of Anatomy and Embryology1, and Radiodiagnosis and Intervention2, Faculty of Medicine, University of Alexandria.
Introduction: Knowledge of the variations of the carotid arteries as regard the origin, course and branches and its relations is of great importance in surgery of the neck and radiological examination. Aim of the work: The aim of this work was to study the origin, course, branches and diameters of the arteries in the carotid triangle. These measures were done to clarify the anatomical basis for the possible clinical applications. Material & Methods: The study included both an anatomical and a radiological once. The anatomical study was carried out on twenty halves cadaveric formalinized head and neck specimens. These were obtained from the Dissecting Room, Anatomy Department, Faculty of Medicine, Alexandria University. Ten of these were injected with red latex and lead oxide. Thirty adult patients (males and females) were obtained from the Radiology Department, Alexandria Main University Hospital. They were subjected to Doppler study on their carotid system using the Triplex Doppler machine. These patients complained from cerebral symptoms or thyroid disorders. Doppler imaging of the arteries of the brain and arteries of the neck was recommended. Consents of these patients were taken to examine their carotid system to be used in this study. Those who proved to have a disease in the carotid system were excluded. Results: The results of the present study revealed variations in the level of the common carotid artery either higher or lower level of bifurcation, variations in the position of the hypoglossal nerve in relation to carotid bifurcation. Also, there was variations in the origin of the main branches of the external carotid artery. In addition, there was variation in the course of the internal carotid artery either straight, tortuous or curved course. The external carotid artery was found anterior to the internal carotid artery, anteromedial or lateral. The facial artery had the largest diameter among the branches of the external carotid artery. The ratio (ICA/ CCA) was larger in females than in males. Females had a larger internal carotid artery than males. The ratio (ECA/CCA) was larger in males than in females. This indicated that the external carotid artery diameters were larger in males than in females. Conclusion: There are significant variations in the carotid arterial system as regard their origin, course and branches which are important to decrease the risk in head and neck surgery and for accurate radiological examination.
December 2011