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Updated: Apr 30, 2026

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
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A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis

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The clinical impact of aberrant internal carotid arteries in children

Christoph Becker1, Gerd J Ridder1, Jens Pfeiffer1

  • 1Department of Otorhinolaryngology - Head and Neck Surgery, University of Freiburg, Freiburg 79106, Germany.

International Journal of Pediatric Otorhinolaryngology
|May 6, 2014
PubMed

Insights

Aberrant internal carotid arteries (ICAs) are congenital variations. While often asymptomatic, these anatomical variations pose a significant risk of injury during head and neck procedures, necessitating anticipation.

Area of Science:

  • Anatomy
  • Vascular Surgery
  • Pediatric Medicine

Background:

  • Variations in the internal carotid artery (ICA) course are common congenital anomalies.
  • These aberrant ICAs can present unique challenges in head and neck surgical and interventional procedures.

Purpose of the Study:

  • To investigate the clinical significance of aberrant internal carotid arteries in pediatric patients.
  • To assess the potential risks associated with these variations during surgical and interventional procedures in the head and neck region.

Main Methods:

  • Retrospective analysis of vessel courses in pediatric patients (<18 years) over 4.5 years.
  • Classification of vessel aberrations using the Weibel and Fields anatomic system.
  • Correlation with a clinicoradiological risk classification system to evaluate injury potential.

Main Results:

  • Fourteen aberrations (4 tortuosities, 7 kinkings, 3 coilings) identified in 9 pediatric patients.
  • All aberrations were incidental findings; no patient presented with distinct symptoms.
  • The minimum distance from aberrant ICAs to the pharyngeal wall varied (0.8–9.0 mm, mean 3.8 mm); no correlation between anatomic classification and clinical injury risk.

Conclusions:

  • Aberrant internal carotid arteries increase the risk of vascular injury during routine head and neck procedures.
  • Preoperative imaging should be considered, especially for pharyngeal surgeries and interventions, to anticipate these anatomical variations.
  • Anticipating aberrant ICAs is crucial for patient safety in pediatric head and neck interventions.
Abstract

Keywords:
Branchial arteriesCarotid kinkingClassificationInternal carotid arteryParapharyngeal massesTonsillectomy and adenoidectomy

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