Unusual branching pattern of the external carotid artery in a cadaver

With the increasing use of invasive diagnostic and interventional procedures in cardiovascular disease, it is important to document and understand the types and frequencies of vascular variations. A sound knowledge of neurovascular variations is important for surgeons who remove cervical lymph nodes, for anesthesiologists, and for vascular surgeons. The external carotid arterial system is a complex vascular system which nourishes the terminal areas of the head, face and neck. The branches of the external carotid artery are the key landmarks for adequate exposure and appropriate placement of cross-clamps on the carotid arteries during carotid endarterectomy, and understanding their anatomy is necessary to successfully remove plaque and minimize postoperative complications in a bloodless surgical field. Variations in the course, branching, and distribution of the carotid arteries are commonly encountered. We report an extremely rare variation in the branching of the external carotid artery noted during routine cadaver dissection. All branches in the carotid triangle arose close together from a common point just above the origin of the external carotid artery from the common carotid artery. The clinical importance of this variation is discussed.