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Caution with carotids: A necessary cognizance.

Adarsh Kudva1, Vasantha Dhara1, B R Patil2

  • 1Dept Of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Karnataka 576104, India.

Oral Oncology
|June 25, 2021
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Summary

Morphological variations in the cervical internal carotid artery, such as tortuosity and kinking, are often asymptomatic but can cause vascular accidents if not identified. Awareness and precautions are crucial during head and neck surgeries to prevent patient morbidity.

Keywords:
AberrationInternal carotid arteryNeck dissectionOral cavityPharynx

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Area of Science:

  • Vascular Surgery
  • Anatomical Variations
  • Cranial Nerve Surgery

Background:

  • Aberrations in the cervical course of the internal carotid artery (ICA) are frequently incidental findings due to their asymptomatic nature.
  • Morphological variations like tortuosity, kinking, and coiling of the ICA can lead to significant complications if not identified pre-operatively or intra-operatively.
  • Awareness of these anatomical variations is essential for surgeons performing procedures in the head and neck region.

Observation:

  • A case series of four patients presenting with carotid dolichoarteriopathies during neck dissection is presented.
  • These vascular anomalies were observed as incidental findings during the surgical procedure.
  • The study focuses on the clinical significance of these variations in the context of neck dissection.

Findings:

  • Carotid dolichoarteriopathies, encompassing tortuosity, kinking, and coiling of the ICA, represent significant anatomical variations.
  • Failure to recognize these variations can result in intra-operative or post-operative vascular accidents.
  • The observed cases highlight the potential for morbidity associated with unaddressed cervical ICA aberrations.

Implications:

  • Pre-operative identification and awareness of cervical ICA variations are critical for surgical planning and patient safety.
  • Implementing specific precautions during head and neck surgeries can mitigate the risk of vascular complications.
  • This case series underscores the importance of meticulous anatomical assessment to prevent iatrogenic injuries and improve patient outcomes in vascular and head and neck surgery.