Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Medical College and the First Affiliated Hospital of Chengdu Medical College, Chengdu, 610500, People's Republic of China.
Department of Gastroenterology, Clinical Medical College and the First Affiliated Hospital of Chengdu Medical College, Chengdu, 610500, People's Republic of China.
Surg Radiol Anat. 2021 Nov;43(11):1765-1768. doi: 10.1007/s00276-021-02771-0. Epub 2021 May 21.
Tortuosity of the internal carotid artery (ICA) is not a rare condition, but its clinical impact is underestimated. The differences in the course and shape of the ICA in the oropharynx just beneath the mucosa were investigated to determine the possible fatal bleeding for both major oropharyngeal tumor resection and less extensive procedures. We report two cases to reveal that the awareness of such an anatomical variation before performing oropharyngeal procedures.
We report two different pathologies of retropharyngeal ICAs, which presented with otolaryngological symptoms. Case 1 Retropharyngeal right ICA. The vessel's minimum distance to the pharyngeal wall was 1 mm (very high risk of vascular injury) with a tortuous pathway. Case 2 Retropharyngeal right ICA. A tortuous ICA was in contact with the posterior pharyngeal wall (very high risk of vascular injury).
The otolaryngologists surgeons must use caution in evaluating patients with masses in the pharynx and augment a careful and complete head and neck examination with appropriate imaging studies before operating.
颈内动脉（ICA）迂曲并不罕见，但临床重视度不足。本研究旨在探讨口咽黏膜下 ICA 走行及形态的差异，以便为大型口咽肿瘤切除术和较小范围手术提供可能致命的出血风险预测。我们报告两例病例，旨在提醒在进行口咽手术前注意这种解剖变异。
我们报告了两种不同的咽后 ICA 病理，它们表现为耳鼻喉科症状。病例 1：右侧咽后颈内动脉。血管距咽壁最近处仅 1 毫米（血管损伤风险极高），路径迂曲。病例 2：右侧咽后颈内动脉。迂曲的颈内动脉与咽后壁接触（血管损伤风险极高）。
耳鼻喉科医生在评估咽内肿块患者时必须谨慎，并在手术前进行仔细和完整的头颈部检查以及适当的影像学研究。
