Paulsen F, Tillmann B, Christofides C, Richter W, Koebke J
Department of Anatomy, Christian Albrecht University of Kiel, Germany.
J Anat. 2000 Oct;197 Pt 3(Pt 3):373-81. doi: 10.1046/j.1469-7580.2000.19730373.x.
Variations of the course of the internal carotid artery in the parapharyngeal space and their frequency were studied in order to determine possible risks for acute haemorrhage during pharyngeal surgery and traumatic events, as well as their possible relevance to cerebrovascular disease. The course of the internal carotid artery showed no curvature in 191 cases, but in 74 cases it had a medial, lateral or ventrocaudal curve, and 17 preparations showed kinking (12) or coiling (5) out of a total of 265 dissected carotid sheaths and 17 corrosion vascular casts. In 6 cases of kinking and 2 of coiling, the internal carotid artery was located in direct contact with the tonsillar fossa. No significant sex differences were found. Variations of the internal carotid artery leading to direct contact with the pharyngeal wall are likely to be of great clinical relevance in view of the large number of routine procedures performed. Whereas coiling is ascribed to embryological causes, curving is related to ageing and kinking is thought to be exacerbated by arteriosclerosis or fibromuscular dysplasia with advancing age and may therefore be of significance in relation to the occurrence of cerebrovascular symptoms.
研究了咽旁间隙内颈内动脉走行的变异情况及其出现频率，以确定咽部手术和外伤时急性出血的潜在风险，以及它们与脑血管疾病的可能关联。在265个解剖的颈动脉鞘和17个铸型血管标本中，191例颈内动脉走行无弯曲，但74例有内侧、外侧或腹尾侧弯曲，17个标本出现扭结（12例）或盘绕（5例）。在6例扭结和2例盘绕中，颈内动脉与扁桃体窝直接接触。未发现明显的性别差异。鉴于大量常规手术的开展，颈内动脉走行变异导致与咽壁直接接触可能具有重要的临床意义。盘绕归因于胚胎学原因，弯曲与衰老有关，扭结被认为随着年龄增长会因动脉硬化或纤维肌发育异常而加剧，因此可能与脑血管症状的发生有关。
