Carotid bifurcation - clinical relevance

Abstract

Common carotid artery bifurcation (CCAb) branches and topography of surrounding structures are essential for diagnosis and surgical procedures in the neck. The aim of this study was to add evidence of the variability found in the CCAb region relative to bifurcation location, arterial carotid branches and surrounding structures in the studied sample. This study was performed on 38 CCAbs from 19 cadavers. The CCAbs were located at the level of the superior border of the thyroid cartilage (TC) in 63.15% (24/38) of the cases, and at the hyoid bone (HB) level in 36.85% (14/38) of the sample. There was asymmetry between the right and the left side in 10.52 % (2/19) of the cadavers. The superior thyroid artery (STA) arose from the common carotid artery (CCA) or the CCAb in 34.21% (13/38) of the cases. The ascending pharyngeal artery (APA) arose from the internal carotid artery (ICA) in 2.6% (1/38) of the cases. The vagus nerve (VN) ran posterior to the CCAb in 89.48% (34/38) of the cases, and anterolateral in 10.58% (4/38) of the cases. The carotid body (CB) was found posterior in the angle of the CCAb in 73.68% (28/38) of the cases. The carotid bifurcation region showed a considerable variability in the studied sample. The findings of the study, together with other previously published studies, should be taken into consideration by physicians and surgeons to avoid clinical complications.