Carotid Anomalies and Their Implication in ENT Surgery.

Area of Science:

• Vascular Surgery
• Otorhinolaryngology
• Pediatric Surgery

Background:

• Carotid artery anomalies present unique challenges in head and neck surgery.
• Variations can lead to significant surgical implications, particularly for Otorhinolaryngologists.
• Awareness of these anomalies is critical for patient safety during surgical procedures.

Purpose of the Study:

• To highlight the surgical implications of carotid artery anomalies.
• To emphasize the importance of recognizing carotid variations in nasopharyngeal and oropharyngeal surgery.
• To present case studies illustrating the diagnostic and management challenges.

Main Methods:

• Case study review of two patients with significant carotid artery anomalies.
• Discussion of clinical presentation, diagnostic evaluation, and surgical management strategies.
• Literature review on the incidence and impact of carotid variations in relevant surgical fields.

Main Results:

• A child with Pierre Robin Syndrome and bilateral midline carotids experienced severe obstructive sleep apnea (OSA) due to airway compromise.
• An adult presented with cervical dysphagia and was found to have retropharyngeal carotids, mimicking chronic tonsillitis.
• Both cases underscore the potential for catastrophic outcomes if anomalies are unrecognized.

Conclusions:

• A high index of suspicion is necessary for identifying carotid artery variations.
• Early and accurate diagnosis of carotid anomalies is vital for safe surgical planning.
• Otorhinolaryngologists must be aware of these vascular variations to avoid surgical misadventures.