[Clinical analysis of cervical internal carotid artery malformation]

Objective:To introduce the clinical features and clinical imaging grading methods of cervical internal carotid artery（ICA） malformation. Methods:The clinical data of 6 cases with cervical ICA malformation admitted to the department of Otolaryngology, Head and Neck Surgery, the First Affiliated Hospital of Chengdu Medical College from April 2018 to February 2021 were retrospectively analyzed and graded according to the clinical imaging grading method. Results:All 6 patients were confirmed by enhanced CT or CT angiography. The minimum distance from deformity ICA to pharyngeal mucosa was 0 - 2.0 mm, while the median distance was 1.3 mm. According to the clinical imaging grading standards, the four cases with oropharyngeal ICA were grade Ⅳ, which is considered extremely high risk of ICA injury. The two cases with hypopharyngeal ICA were grade Ⅲ, which is considered high risk of ICA injury. Conclusion:ICA malformation is not a rare condition, and can be definitively diagnosed by enhanced CT and CT angiography. The clinical imaging grading can be used to assess the risk of damaged ICA malformation, which has great clinical significance. Otolaryngologists and anesthesiologists should pay attention to this malformation to prevent ICA damage in the operation which could lead to fatal hemorrhage.