The external carotid artery begins at the upper border of thyroid cartilage, and curves, passing forward and upward, and then inclining backward to the space behind the neck of the mandible, where it divides into the superficial temporal and maxillary artery within the parotid gland. It rapidly diminishes in size as it travels up the neck, owing to the number and large size of its branches. At its origin, this artery is closer to the skin and more medial than the internal carotid, and is situated within the carotid triangle:. Para algunas cookies, su consentimiento es necesario. Como parte del e-learning cuando ve un video, nuestro proveedor de servicios Vimeo deposita cookies.
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Carotid bifurcation CB , which is one of the place where the atherosclerotic plaques are most commonly seen. The surgical procedure of these plaques which causes cerebral vascular accident CVA is carotid endarterectomy.
In this surgical procedure, the knowledge of the anatomical courses and variations of the carotid artery increased the surgery performance. In our study, we aimed to introduce the course, the location and the variation of the ECA's and their branches. This study is carried out on multidetector computerized tomography angiography of the ECA's of 50 men and 50 women, totally ECA's right, left.
The location of the CB was determined and its vertical distance to the gonion measured. The ECA and its branches were recorded. We believe that the assessment of the ECA morphometrically may comprise control groups of diseases related to the vessel diameter and this data may be used as reference in clinic and surgery. Knowing the anatomical details and variations is vital to prevent unpredictable complications in surgery.
La ACE y sus ramas se registraron. The neck region is of great vital value because of the link between head and trunk, upper limb. The external carotid artery, feeds the structures of the face, the scalp, upper part of the thyroid gland and some part of the dura mater, is main artery of the head and neck region Mahendrakar, ; Mamatha et al.
The carotid bifurcation is the place in where atherosclerotic plaque is most commonly seen. Stenosis of the carotid arteries is important cause of the CVA. The formation of the atherosclerotic plaques is closely related to the anatomy of the CB which effects cervical blood flow Takahashi et al.
The most common treatment of these plaques, which causes the CVA, is endartrectomy. Surgical procedures require that both atherosclerotic plaques and tunica intima are removed.
In this type of surgical procedure, knowing the details of the anatomy and variations of the carotid arteries may increase the surgical success. Knowledge about the CCA, ECA and its branches and variations show that they are very important in radiologic diagnosis and surgery Gluncic et al.
Similarly in surgery performed in the carotid trigonum, the knowledge of the anatomy is necessary Gluncic et al. In this study we evaluated the morphometric analysis of ECA and its branches, the properties, the origin of the branches and variations of bifurcation in adults.
We aimed to compare these feature according to sex and the sides, to detect the prevalence and to provide helpful information for surgery intervention performed in these areas in the scope of the obtained data.
This study was carried out on images obtained with multidetector CT angiography MDCTA technique, from sample right, left of patients 50 men, 50 women who were referred to the CT angiography, did not have any carotid artery disease, in the Department of Radiodiagnostics, Faculty of Medicine, Necmettin Erbakan University. We planned our study as three stage; the preparation of materials, the assessment of the ECA and its branches and the examining its variations, and statistical analysis. All of the stage was performed by the same researcher to minimize the risk of error.
Then the volumetric and sub-volumetric images which could be appropriate to assess the arterial structure reformatted in the sagittal, coronal, axial plane with MIP maximum intensity projection , MPR multiplanar reformation and VRT volume rendering technique were identified. The measurements were performed on these samples. All patients were in supine position when they were examined by the MDCTA so the standardized data were obtained.
The obtained standardized data is important for the reliability of the study. In multi-planar images; the position of the CB according to the cervical C vertebrae levels Fig. Meanwhile the anatomic variations were studied on these images. Thus, the second stage of our study was completed. In the third stage of our study, the obtained data were analyzed with S.
Normal distribution assumption was evaluated by using Kolmogorov-Smirnov test. Student-t test was used to compare groups, Pearson correlation test was used for relation between parameters.
Mann-Whitney U test was used to compare medians of non-normal distribution, Wilcoxon W test was used to analyze non-parametric independent variables. The measurement of inner diameter of the external carotid artery ECA. The position of the CB according to the cervical C vertebrae levels and the hyoid bone.
All of the data were categorized according to the sexes men-women and the sides the right-the left. Subjects with the anatomic variations were excluded while parameters were measured. The Findings related to the CCA. Mean values were 6. These data were compared according to the sex and the sides. The findings related to the CB. The vertical distance of the CB to the gonion in horizontal plane was measured. The mean values of them at the right side is Also there were no significant differences in lateralization Table II.
Carotid bifurcation level was compared to the level of cervical vertebra and their frequency was expressed as percentages. We found that the CB was between C2 and C3 in 14 subjects 7. Additionally, we evaluated location of the CB according to the hyoid bone. The CB was lower than the level of the hyoid bone in 38 No statistically significant differences were observed in lateralization Table II. Table I. Table II. The vertical distance between the LA and the CB was measured in samples, 51 samples have variations.
We found that the distance between the LA and CB were There were no statistically significant differences both between women and men, and lateralization Tables I and II. While the vertical distance between the FA and the CB was measured, 47 samples were excluded due to having variations.
So samples were included this measurement. The distances were There were statistically significant differences both between women and men, and lateralization Tables I and II. The vertical distance between the OA and the CB was measured in samples which have no variations.
The distance was measured as The findings related to the ECA and its branches. The ECA lay differently in 11 5. In one sample, the occipital artery was separated at the middle of the CB. The OA was originated from almost every levels of the ECA so the obtained data did not present non-normal distribution. Non-parametric tests were used to analyze the data and the values of standard deviations were quite high.
The lateral position of the external carotid artery ECA. The CCA was studied by the many investigators and they reported that the results of their study were associated with the cardiovascular related risk factors Kawamoto et al. The association between atherosclerotic risk factors and luminial diameter is a truism and previous studies suggested that the development of the atherosclerotic plaques compensate for luminal enlargement Ozdemir et al.
Krejza et al. Kozova et al. Johsen et al. In our study, the lumen diameter of the CCA was measured as 6. Our findings related to the lumen diameter were similar to those reported in literature and a statistically significant difference was observed between women and men. Previous studies investigated intensively the relation between the anatomy of the CB and the hemodynamics.
Our study supported the findings of the previous studies which reported that the CB was found mostly between C3 and C4. Lucev et al. We found that the CB were below the hyoid bone in Our findings suggested that most of the CCA bifurcated above the hyoid bone and these findings were similar to the findings of Lucev et al. Ozgur et al. Our findings were Our study presented findings different than those of previous studies.
There are different surgery techniques related to the artery ligation in the carotid triangle. The lateral position of the external carotid artery were firstly reported by Hirtl in in literature.
Currently this phenomenon was not common as much as reported previously. Ueda et al. In our study, the incidence was 5. Lo et al. Similarly In our study, the diameter of the ECA was 4. The variations in the origin of the STA are very important in surgery.
Vazquez et al. Our findings are not concordant with the literature. While Vazquez et al. Hayashi et al. The mean distances in originated from the ECA were 4. Fazan et al. In the study we found that the mean distances were
The external carotid artery begins at the upper border of thyroid cartilage, and curves, passing forward and upward, and then inclining backward to the space behind the neck of the mandible, where it divides into the superficial temporal and maxillary artery within the parotid gland. It rapidly diminishes in size as it travels up the neck, owing to the number and large size of its branches. At its origin, this artery is closer to the skin and more medial than the internal carotid, and is situated within the carotid triangle:. Alguns cookies necessitam seu consentimento. Clique em cada categoria de cookies para ativar ou desativar seu uso.