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Curving and looping of the internal carotid artery in relation to the pharynx: frequency, embryology and clinical implications

Published online by Cambridge University Press:  23 November 2000

FRIEDRICH PAULSEN ,
BERNHARD TILLMANN ,
CHRISTOS CHRISTOFIDES ,
WALBURGA RICHTER  and
JÜRGEN KOEBKE
FRIEDRICH PAULSEN
Affiliation:
Department of Anatomy, Christian Albrecht University of Kiel, Germany
BERNHARD TILLMANN
Affiliation:
Department of Anatomy, Christian Albrecht University of Kiel, Germany
CHRISTOS CHRISTOFIDES
Affiliation:
Department of Anatomy, Christian Albrecht University of Kiel, Germany
WALBURGA RICHTER
Affiliation:
Department of Anatomy II, Albertus Magnus University of Cologne, Germany
JÜRGEN KOEBKE
Affiliation:
Department of Anatomy II, Albertus Magnus University of Cologne, Germany
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Abstract

Variations of the course of the internal carotid artery in the parapharyngeal space and their frequency were studied in order to determine possible risks for acute haemorrhage during pharyngeal surgery and traumatic events, as well as their possible relevance to cerebrovascular disease. The course of the internal carotid artery showed no curvature in 191 cases, but in 74 cases it had a medial, lateral or ventrocaudal curve, and 17 preparations showed kinking (12) or coiling (5) out of a total of 265 dissected carotid sheaths and 17 corrosion vascular casts. In 6 cases of kinking and 2 of coiling, the internal carotid artery was located in direct contact with the tonsillar fossa. No significant sex differences were found. Variations of the internal carotid artery leading to direct contact with the pharyngeal wall are likely to be of great clinical relevance in view of the large number of routine procedures performed. Whereas coiling is ascribed to embryological causes, curving is related to ageing and kinking is thought to be exacerbated by arteriosclerosis or fibromuscular dysplasia with advancing age and may therefore be of significance in relation to the occurrence of cerebrovascular symptoms.

Keywords

Branchial arteriestonsillectomyhaemorrhagecerebrovascular haemodynamic changes
Type
Research Article
Information
The Journal of Anatomy , Volume 197 , Issue 3 , October 2000 , pp. 373 - 381
Copyright
© Anatomical Society of Great Britain and Ireland 2000

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