Course anomalies of extracranial internal carotid artery and their relationship with pharyngeal wall: An evaluation with multislice CT

Radiology Department, Dicle University, School of Medicine, 21280, Diyarbakir, Turkey.
Anatomia Clinica (Impact Factor: 1.05). 03/2012; 34(7):625-31. DOI: 10.1007/s00276-012-0958-3
Source: PubMed


The goal of our study was to measure the prevalence of anomalies in the extracranial segment of internal carotid artery (ICA), to measure the carotid-pharyngeal distance (CPD).
Computed tomography (CT) angiography images of 607 patients were retrospectively examined. The course anomaly and CPD were obtained at different image plane. The patients were divided into four groups according to their age.
The incidence of course anomaly in ICA was shown to be 60.3 %. Prevalence of course anomaly showed an increase with age (p < 0.001). Women had more ICAs with a course anomaly than men (p < 0.001). Mean CPD among all ICAs was found to be 11.13 mm. When CPD values were compared between the groups, group 1 and group 2 did not have a significant difference, however, there was a significant difference between other groups (p < 0.05). The CPD significantly decreased with age (p < 0.001). In ICAs that showed a straight course, the mean CPD was 13.0 mm, while in ICAs that showed course anomaly, the mean CPD was determined to be 9.49, showing a significant difference (p < 0.05).
In conclusion, the number of ICAs that show a course anomaly increases with age, while the CPD decreases. The CPD is decreased in groups that show anomalies. The detection of a decreased CPD before surgery may lower the chance of a perioperative hemorrhage due to artery damage during pharyngeal procedures. Hence, while reporting neck CT angiographies, it may be valuable to also report the presence of ICA anomalies and CPD.

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    ABSTRACT: A five years old female, presented with long standing snoring & recurrent tonsillitis. Examination showed pulsating soft palate & posterior pharyngeal wall. Magnetic resonance angiography (MRA) of the carotids revealed abnormal course of the right internal carotid artery (ICA) with its proximal segment coursing medially and reaching the midline of the retropharyngeal space. The right ICA kinked 2.3 cm medially. It was 3.1 mm posterior to the right palatine tonsil & 3.5 mm away from posterior part of the adenoid. The dilemma of undergoing adenotonsillectomy was considered to be of a high risk & the patient was kept on conservative management only.
    No preview · Article · Jan 2013 · International Journal of Pediatric Otorhinolaryngology Extra