Anat Cell Biol.  2018 Dec;51(4):225-231. 10.5115/acb.2018.51.4.225.

A cadaveric study on variations in branching pattern of external carotid artery

• Devadas D
• Pillay M
• Sukumaran

• KMID: 2430188
• DOI: http://doi.org/10.5115/acb.2018.51.4.225

Abstract

Variations in the vascular anatomy of the carotid triangle have been reported in current scientific literature. The carotid arteries, being the major feeding arteries of the head and neck deserve special importance and protection from iatrogenic injury during radiological evaluations and surgical interventions. The present study was carried out over a period of 4 years from 2012-2016 to assess the variant anatomy of external carotid artery. The external carotid artery and its branches were dissected bilaterally in 40 formalin embalmed cadavers. The external carotid artery was traced from its origin to termination and variations in the branching pattern as well as the level of the carotid bifurcation were observed and analysed. A higher carotid bifurcation was observed in 25% cases. The linguofacial trunk was the commonest variation noted in the branching pattern seen in 20% cases. A single case of unilateral thyrolinguofacial trunk was also observed. The external carotid artery gave rise to accessory branches in 7.5% cases namely the superior laryngeal, accessory ascending pharyngeal and masseteric branches. A slender branch to the internal jugular vein was also observed in one case. These findings may provide further insight into the understanding of the vascular anatomy of the carotid triangle to the curious student, the discerning radiologist and the vigilant surgeon to avert complications and help improve overall treatment outcome.

Keyword

Anatomy; Carotid; Variations; Branching pattern

MeSH Terms

Arteries
Cadaver*
Carotid Arteries
Carotid Artery, External*
Formaldehyde
Head
Humans
Jugular Veins
Neck
Treatment Outcome
Formaldehyde

Figure

• 

  Fig. 1 High origin of left external carotid artery between upper border of thyroid cartilage and greater cornua of hyoid bone (2a). CCA, common carotid artery; ECA, external carotid artery; GC, greater cornua of hyoid bone; ICA, internal carotid artery; TC, thyroid cartilage.

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  Fig. 2 Higher origin at the level of greater cornua of hyoid bone (right side, 2b). CCA, common carotid artery; DG, digastric; ECA, external carotid artery; GC, greater cornua of hyoid bone; HN, hypoglossal nerve; ICA, internal carotid artery; IJV, internal jugular vein; SH, stylohyoid; TC, thyroid cartilage.

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  Fig. 3 Higher origin above the level of greater cornua of hyoid bone (right side, 2c). CCA, common carotid artery; ECA, external carotid artery; GC, greater cornua of hyoid bone; TC, thyroid cartilage.

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  Fig. 4 Thyrolinguofacial trunk observed in a cadaver (right side). APA, ascending pharyngeal artery; CCA, common carotid artery; DG, digastric; ECA, external carotid artery; FA, facial artery; HN, hypoglossal nerve; ICA, internal carotid artery; LA, lingual artery; LFT, linguofacial trunk; OA, occipital artery; SH, stylohyoid; SLA, superior laryngeal artery; SMG, submandibular gland; STA, superior thyroid artery; TLFT, thyrolinguofacial trunk.

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  Fig. 5 High origin of ascending pharyngeal artery (left side). APA, ascending pharyngeal artery; CCA, common carotid artery; DG, digastric; ECA, external carotid artery; FA, facial artery; HN, hypoglossal nerve; ICA, internal carotid artery; IJV, internal jugular vein; LA, lingual artery; OA, occipital artery; SH, stylohyoid; STA, superior thyroid artery.

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  Fig. 6 Double ascending pharyngeal arteries in a cadaver (right side). APA, ascending pharyngeal artery; CCA, common carotid artery; DG, digastric; ECA, external carotid artery; FA, facial artery; HN, hypoglossal nerve; ICA, internal carotid artery; LA, lingual artery; LFT, linguofacial trunk; OA, occipital artery; OH-S, omohyoid (superior belly); SH, stylohyoid; SLA, superior laryngeal artery; STA, superior thyroid artery.

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  Fig. 7 Masseteric branch of ECA in the parotid region (right side). CCA, common carotid artery; DG, digastric; ECA, external carotid artery; FA, facial artery; HN, hypoglossal nerve; ICA, internal carotid artery; IJV, internal jugular vein; ILN, internal laryngeal nerve; LA, lingual artery; M, masseter; MB, muscular branch (to masseter); OA, occipital artery; OH-S, omohyoid (superior belly); PAA, posterior auricular artery; PG, parotid gland; SH, stylohyoid; SLA, superior laryngeal artery; STA, superior thyroid artery; VN, vagus nerve.

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  Fig. 8 Branch from ECA to Internal jugular vein (left side). Br.IJV, branch to internal jugular vein; CCA, common carotid artery; DG, digastric; ECA, external carotid artery; IJV, internal jugular vein; OH-S, omohyoid (superior belly); SH, stylohyoid; SMG, submandibular gland; STA, superior thyroid artery.

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  Fig. 9 SLA arising from ECA behind the TLFT (right side). CCA, common carotid artery; DG, digastric; ECA, external carotid artery; FA, facial artery; HN, hypoglossal nerve; ILN, internal laryngeal nerve; LA, lingual artery; SH, stylohyoid; SLA, superior laryngeal artery; STA, superior thyroid artery; TLFT, thyrolinguofacial trunk.

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