Anat Cell Biol.  2024 Jun;57(2):324-327. 10.5115/acb.23.306.

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

• Raviteja P
• Chandrupatla M
• Motwani R

• KMID: 2556578
• DOI: http://doi.org/10.5115/acb.23.306

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.

Keyword

Carotid arteries; Neck; Aneurysm; Cadaver; Classification of the external carotid artery

Figure

• 

  Fig. 1 Shows tri-ramification of both left common and external carotid arteries (ECA) and common trunks of ECA and aneurysm. 1, left common carotid artery; 2, pharyngo-occipital trunk; 3, ascending pharyngeal artery; 4, occipital artery; 5, posterior auricular artery; 6, aneurysm of the distal part of the left external carotid artery; 7, internal carotid artery; 8, linguo-facial trunk; 9, facial artery; 10, lingual artery; 11, superior thyroid artery; A, anterior; P, posterior; S, superior; I, inferior.

• 

  Fig. 2 Schematic diagram of variation of the left external carotid artery (LECA). 1, left common carotid artery; 2, pharyngo-occipital trunk; 3, ascending pharyngeal artery; 4, occipital artery; 5, posterior auricular artery; 6, aneurysm of the distal part of the LECA; 7, internal carotid artery; 8, linguo-facial trunk; 9, facial artery; 10, lingual artery; 11, superior thyroid artery; A, anterior; P, posterior; S, superior; I, inferior.

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  Fig. 3 Punnapatla classification of the external carotid artery branching pattern variations. Sup. TA, superficial temporal artery; MA, maxillary artery; PAA, posterior auricular artery; OA, occipital artery; FA, facial artery; LA, lingual artery; APA, ascending pharyngeal artery; STA, superior thyroid artery; TLFT, thyro-linguo-facial trunk; TLT, thyro-lingual trunk; LFT, linguo-facial trunk; POT, pharyngo-occipital trunk; AOT, auriculo-occipital trunk; A, anterior; P, posterior; S, superior; I, inferior.

Reference

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