From the Department of Surgery, Division of GI/Endocrine Surgery (G.K.S., C.M.M., J.A.L., J.H.K.), Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York.
Department of Radiology (R.Y.), Memorial Sloan Kettering Cancer Center, New York, New York.
AJNR Am J Neuroradiol. 2021 Apr;42(4):749-752. doi: 10.3174/ajnr.A6995. Epub 2021 Feb 18.
The carotid arteries, classically described as taking a relatively straight course through the neck, deviate medially in a minority of patients. At the extreme, the internal carotid arteries may "kiss" in the midline, coming extremely close to the pharyngeal wall. In this clinical report, we describe 5 patients with primary hyperparathyroidism, all with ectopic retropharyngeal parathyroid adenomas but all with varying carotid artery anatomy. We describe these variations using a previously developed clinical grading system that highlights 1) the relationship between carotid artery location and risk of injury during pharyngeal procedures and 2) the importance of universal, objective criteria to classify carotid anatomy. Radiologists should be familiar with variations in carotid anatomy and communicate them to the operative team.
颈总动脉在颈部通常呈相对直的走行，但在少数患者中会向内侧偏斜。在极端情况下，颈内动脉可能会在中线“亲吻”，非常接近咽壁。在本临床报告中，我们描述了 5 例原发性甲状旁腺功能亢进症患者，均为异位咽后甲状旁腺腺瘤，但颈总动脉解剖结构各异。我们使用先前开发的临床分级系统描述这些变异，该系统突出了 1）颈动脉位置与咽后手术过程中损伤风险之间的关系，以及 2）对颈动脉解剖进行分类的通用客观标准的重要性。放射科医生应熟悉颈动脉解剖的变异，并将其传达给手术团队。
