Radiological observation of external carotid artery in Korea

Lee, J T; Park, C Y; Choi, B S

Abstract

The external carotid arteriogram is useful in the diagnosis of the head and neck disease, however the clinicalutility has not been widely obtained in contrast with the internal carotid arteriogram of the intracranial lesion.It is partially because the distribution and shape of external carotid arterial branches are variable andcomplicated according to underlying mechanical factors in the normal condition, other partiality is th ediagnosisof head and neck disease has been established easily by other clinical methods. Recently, the external carotidarteriogram is indispensable for the detection and the determination of the location and extension of head andneck lesion, especially in the case of early and small malignancy. For this reason amongst the normal distributionand variation of the external carotid arterial branches should be analysed to fulfill these purpose. At theDepartment of Radiology, Severance Hospital, College of Medicine, Yonsei University, the normal external carotidarteriogram of the selected 106 cases in which the common carotid artery puncture had been performed for theinternal carotid arteriography to evaluate the intracranial lesion, was conjoined. Therefore, the observation andanalysis were limited to the shape and variable origination, the visualization and the direct distance from theroot of external carotid artery of main branches. The results were as follows : 1. The bifurcation level of commoncartery artery is C3-C4 in 52.8%, C2-C3 in 34.9% and C4-C5 in 10.4% (range;C2-C5) 2. The shape of external carotidartery from the root to the terminal bifurcation is variable, the straight and the curved shape are more frequentin the young adult before 5th decade, whereas the waved and the arch shape are more in the older age group. Thisfact suggest the arteriosclerotic change of blood vessel by aging process. 3. The superior thyroidal artery arisesfrom the external carotid artery in 49.5% and from the common carotid artery in 23.8%. 4. The variableoriginations of the superior thyroidal, lingual and facial artery are the normal type of different origin in78.3%, the lingofacial common trunk in 16.1%, thyrolingual common trunk in 3.7% and thyrolingofacial common trunkin 1.9%. 5. The ascending pharyngeal artery arises from the external carotid artery in 24.6%, from the occpitalartery in 23.5%, from the root of occipital artery in 9.8%, and from the internal carotid artery in 1.6%. 6. Thetransverse facial artery arises from the external carotid artery in 27.9%, from the superficial temporal artery in21.5% and from the maxillary artery in 10.5%. 7. The roentgen-anatomical shape of the maxillary artery are dividedby the three part; 1st part of mandibular, 2nd part of pterygoid and 3rd part of sphenomaxillary. The mostfrequent shapes of each part of maxillary artery are the convex in 78.4% of mandibular, the oblique straight in45.8% and the oblique convex in 35.2% of pterygoid and ill defined variable shapes with the straight, the loop andthe arch of sphenomaxillary part. 8. The visualization rate of main branches of the external carotid arteriogramin the case of the performed common carotid arterial puncture is 69.5% in the posterior auricular artery, 70.5% inthe cranial part of superficial temporal artery and 29.5% in the cranial part of middle meningeal artery. 9, Theaccessory middle meningeal artery observed in 18% of total 105 cases. 10. The distance from the root of externalcarotid artery to the origination of main branches is 1) in the range of 5-6cm in 33%, 6-7cm in 26% of themaxillary artery, 2) in the range of 1-2cm in 47.2% and 2-3cm in 25.2% of the occipital artery, 3) in the range of1-2cm in 54% and 2-3cm in 25.2% of the facial artery and 4) in the range of 1-2cm in 55.6% and 0-1cm in 24.7% ofteh lingual artery in the high frequency. (range:0-7cm) 11. The origination of middle meningeal artery is in therange of 0.5-1cm in 57.6% from the root of maxillary artery with the most frequency. (range:0-2cm). In 10.2% themiddle meningeal artery arise from the root of maxillary artery.