Aleksandra Królikowska, Stokłosa Julia, Patkowska Alicja, Rudko Wiktoria, Mazurek Mateusz, Domagała Zygmunt
Clinical and Dissecting Anatomy Students' Scientific Club, Medical Faculty, Wroclaw Medical University, 50-368 Wroclaw, Dolnoslaskie, Poland.
Division of Anatomy, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-368 Wroclaw, Dolnoslaskie, Poland.
J Clin Med. 2025 Sep 5;14(17):6250. doi: 10.3390/jcm14176250.
The superior thyroid artery (STA) exhibits significant anatomical variability, which is crucial for head and neck surgical procedures, particularly free flap reconstruction. This systematic review synthesizes the current knowledge on STA origin, branching patterns, perfusion territory, and its relationship with the superior laryngeal nerve (SLN), focusing on implications for flap selection and surgical planning. A comprehensive search of relevant databases was conducted to identify studies reporting on STA anatomy. Data extraction focused on the STA origin variations, relationships with anatomical landmarks, branching patterns, perfusion territory, and the STA-SLN relationship. Emphasis was placed on variations impacting STA's suitability as a recipient vessel for free flaps. Data were synthesized qualitatively. The STA most commonly originates from the external carotid artery (ECA), with variations from the carotid bifurcation (CB) and common carotid artery (CCA). Sex-based and laterality differences were noted. Branching patterns varied considerably, influencing perfusion of the thyroid gland, larynx, and adjacent musculature. The STA's relationship with the external branch of the SLN (EBSLN), classified by Cernea's classification, highlighted the risk of iatrogenic injury. The STA provides perfusion to the thyroid gland, larynx, sternocleidomastoid muscle, and strap muscles, all of which can be raised as flaps. Understanding STA anatomical variations is essential for surgeons planning free flap reconstruction in the head and neck. This review underscores the importance of preoperative imaging to assess STA suitability as a recipient's vessel and minimize complications. Further research is needed to quantify the impact of STA variations on free flap outcomes.
甲状腺上动脉（STA）表现出显著的解剖变异，这对头颈外科手术，尤其是游离皮瓣重建至关重要。本系统评价综合了关于STA起源、分支模式、灌注区域及其与喉上神经（SLN）关系的现有知识，重点关注对皮瓣选择和手术规划的影响。对相关数据库进行了全面检索，以识别报告STA解剖结构的研究。数据提取集中在STA起源变异、与解剖标志的关系、分支模式、灌注区域以及STA与SLN的关系。重点关注影响STA作为游离皮瓣受区血管适用性的变异。对数据进行了定性综合。STA最常见起源于颈外动脉（ECA），也有来自颈动脉分叉（CB）和颈总动脉（CCA）的变异。注意到了基于性别的差异和左右侧差异。分支模式差异很大，影响甲状腺、喉及相邻肌肉组织的灌注。根据塞尔尼亚分类法分类的STA与喉上神经外支（EBSLN）的关系突出了医源性损伤的风险。STA为甲状腺、喉、胸锁乳突肌和带状肌提供灌注，所有这些都可以作为皮瓣掀起。了解STA解剖变异对外科医生规划头颈游离皮瓣重建至关重要。本评价强调了术前影像学评估STA作为受区血管的适用性并尽量减少并发症的重要性。需要进一步研究来量化STA变异对游离皮瓣结果的影响。
