Paullus W S, Pait T G, Rhoton A I
J Neurosurg. 1977 Nov;47(5):713-26. doi: 10.3171/jns.1977.47.5.0713.
Occlusion of the cervical portion of the internal carotid artery (ICA) has been treated by vein graft bypass from the common carotid to the supraclinoid segment. However, this procedure has the disadvantages of requiring temporary occlusion of collateral flow, the short length of ICA available for anastomosis, and the retraction required for exposure of the supraclinoid area. In an attempt to find a more suitable bypass site for grafting, the petrous portion of 50 carotid arteries was studied in cadavers. It was found that there was a 1-cm length of the horizontal segment of the petrous carotid that could be exposed in the floor of the middle fossa lateral to the trigeminal nerve. This segment was covered by dura only or a thin layer of cartilage in approximately half of the specimens. In the remainder, there was often a thin shell of bone covering the artery, which could be drilled away. The petrous portion of the carotid artery had branches in only 38% of specimens, a Vidian branch in 30%, and a periosteal branch in 8%. The carotico-tympanic artery, previously reported to be the most common branch, was not found in a single case. These branches allow the retrograde flow needed to maintain the patency of this segment following proximal occlusions. The relationship of the carotid artery to structures include the cochlea, middle ear, Eustachian tube, tensor tympani muscle, geniculate ganglion, and facial, greater petrosal, and trigminal nerves.
颈内动脉（ICA）颈部闭塞已通过从颈总动脉到床突上段的静脉移植搭桥术进行治疗。然而，该手术存在一些缺点，包括需要暂时阻断侧支血流、可供吻合的颈内动脉长度较短以及暴露床突上段所需的牵拉。为了寻找更合适的移植搭桥部位，对50例尸体的岩骨段颈动脉进行了研究。发现岩骨段颈动脉水平段有1厘米长的部分可在三叉神经外侧的中颅窝底部暴露。在大约一半的标本中，该段仅被硬脑膜或一层薄软骨覆盖。在其余标本中，动脉上常有一层薄骨壳，可将其钻除。颈动脉岩骨段仅在38%的标本中有分支，30%有岩浅大神经分支，8%有骨膜支。先前报道为最常见分支的颈鼓动脉在所有病例中均未发现。这些分支可提供逆行血流，以维持近端闭塞后该段的通畅。颈动脉与包括耳蜗、中耳、咽鼓管、鼓膜张肌、膝状神经节以及面神经、岩大神经和三叉神经等结构的关系。
