Association of high carotid bifurcation and thyrolinguofacial trunk: a rare variation

Variations in the origins and the branching pattern of the carotid system of arteries are not uncommon. Here we report a rare case of higher bifurcation of the common carotid artery (CCA) (at the level of the greater cornu of the hyoid bone), thyrolinguofacial trunk (TLFT) originating from the CCA, superior laryngeal artery (SLA) arising from the external carotid artery (ECA) on the left side, and linguofacial trunk arising from the ECA on the right side. In the present case, the CCA and carotid bifurcation may have arisen from the second aortic arch. The ECA bud could have developed from parts of the first aortic arch and ventral aorta. Thus, the altered blood flow through these vessels due to high carotid bifurcation could have caused disproportionate growth and shift in the origins of the branches of the ECA. An understanding of the bifurcation of the CCA and the branching pattern of the ECA should prove useful to surgeons performing selective intra-arterial chemotherapy for head and neck cancer.