Anomaly of the internal carotid artery detected during tonsillectomy

The blood vessel anomalies of the head-neck area may result in death with massive hemorrhage during head and neck surgery. Although anomalies of internal carotid artery (ICA) are observed particularly on the posterior pharyngeal wall, we may confront them in various localizations. Because of these anomalies, the surgeon must always be aware of this risk during tonsillectomy, adenoidectomy, and uvulopalatopharyngoplasty operations. In our case, an S curling-type anomaly of the ICA has been discovered in the distance of 1 cm to the left tonsil during tonsillectomy. Protecting the ICA, a careful tonsillectomy has been performed by using thermal welding and cold dissection method. Then, anomaly has been confirmed radiologically by angiography. This document emphasizes the fact that the surgeon must provide against vascular anomalies that may be confronted during head-neck surgery and that the preoperative examinations should be assessed within this frame.