Huang Shi, Gong Junrong, Hou Nan, Wang Yi
Department of Otorhinolaryngology Head and Neck Surgery,Clinical Medical College,the First Affiliated Hospital of Chengdu Medical College,Chengdu,610500,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Sep;35(9):818-820;824. doi: 10.13201/j.issn.2096-7993.2021.09.010.
To introduce the clinical features and clinical imaging grading methods of cervical internal carotid artery(ICA) malformation. The clinical data of 6 cases with cervical ICA malformation admitted to the department of Otolaryngology, Head and Neck Surgery, the First Affiliated Hospital of Chengdu Medical College from April 2018 to February 2021 were retrospectively analyzed and graded according to the clinical imaging grading method. All 6 patients were confirmed by enhanced CT or CT angiography. The minimum distance from deformity ICA to pharyngeal mucosa was 0 - 2.0 mm, while the median distance was 1.3 mm. According to the clinical imaging grading standards, the four cases with oropharyngeal ICA were grade Ⅳ, which is considered extremely high risk of ICA injury. The two cases with hypopharyngeal ICA were grade Ⅲ, which is considered high risk of ICA injury. ICA malformation is not a rare condition, and can be definitively diagnosed by enhanced CT and CT angiography. The clinical imaging grading can be used to assess the risk of damaged ICA malformation, which has great clinical significance. Otolaryngologists and anesthesiologists should pay attention to this malformation to prevent ICA damage in the operation which could lead to fatal hemorrhage.
介绍颈内动脉(ICA)畸形的临床特征及临床影像分级方法。回顾性分析2018年4月至2021年2月成都医学院第一附属医院耳鼻咽喉头颈外科收治的6例颈ICA畸形患者的临床资料,并根据临床影像分级方法进行分级。6例患者均经增强CT或CT血管造影确诊。畸形ICA至咽黏膜的最小距离为0~2.0mm,中位距离为1.3mm。根据临床影像分级标准,4例口咽ICA患者为Ⅳ级,被认为ICA损伤风险极高;2例下咽ICA患者为Ⅲ级,被认为ICA损伤风险高。ICA畸形并非罕见疾病,增强CT及CT血管造影可明确诊断。临床影像分级可用于评估ICA畸形受损风险,具有重要临床意义。耳鼻咽喉科医生及麻醉医生应关注此畸形,防止手术中ICA损伤导致致命性出血。