The superior thyroid artery (STA) is the dominant arterial supply of the thyroid gland, upper larynx and the neck region. The knowledge of variations in possible patterns of origin, courses, and branching pattern of the STA is also important for surgical procedures in the neck region, such as emergency cricothyroidotomy, radical neck dissection, catheterization, reconstruction of aneurysm and carotid endarterectomy. The surgical anatomy of the STA was studied in 20 adult Anatolian preserved cadavers between the age of 40 and 70 years. The outer diameter of the STA origin was observed to be 3.53 +/- 1.17 mm. The location of the origin of the STA according to the carotid bifurcation was evaluated as above (25%), below (35%) and at the same level (40%). The distribution patterns of the STA were classified into six types depending on the branching pattern. The outer diameter of the infrahyoid branch, superior laryngeal artery, sternocleidomastoid artery and cricothyroid branch at their origins were observed to be 1.13 +/- 0.14, 1.42 +/- 0.47, 1.54 +/- 0.96 and 1.30 +/- 0.41 mm, respectively. Typical and variant glandular branching patterns were observed in 85 and 15% of the specimens, respectively. The outer diameters of anterior, anteromedial, anterolateral and posterior glandular branches were measured as 2.05 +/- 0.46, 1.41 +/- 0.43, 1.51 +/- 0.41 and 1.73 +/- 0.53 mm, respectively. It is necessary to understand the surgical anatomy of the STA to carry out successful radical neck dissection and to minimize postoperative complications in a bloodless surgical field.
Knowledge of carotid bifurcation (CB), common carotid artery (CCA) and its branches and their recognition during diagnostic imaging are also important for vascular surgical procedures in the region, such as carotid endarterectomy or radical neck dissection, catheterization and aneurysms. The surgical anatomy of the carotid arteries was studied in 20 cadavers. Micrometric values of the CB and its relation with surrounding structures, measurements belonging to the external carotid artery (ECA) and internal carotid artery (ICA), and metric data, such as lower face including the greater horn, laryngeal prominence have been evaluated by making linear measures. The diameter of the CCA at the CB under 2 cm and CB diameter was measured as 8.1 +/- 2.24 mm and 12.79 +/- 2.87 mm, respectively. Evaluating data related to the ICA and the ECA in samples, the aspect was measured the ICA and the ECA in the CB discrimination point as 21.52 +/- 20.53 degrees . In the most location of the ECA origin according to the ICA has been determined as medial position in 35 specimens. The origin of the superior thyroid artery (STA) was found to be at the same level with the CB in 40% and below it in 25% specimens. This study has provided measured objective criteria for the arterial features of the neck region, which are crucial during surgery. The origins of the branches of the CCA act as key landmarks for adequate and appropriate placement of the cross-clamp on the carotid arteries.
We believe that a review of the anatomic characteristics of the popliteal artery and its branches will be beneficial for the surgical approaches and the choice of suitable arterial graft sites.
The neck region has a great vital value; its variations and known micrometric values are accepted as important orientation points during intervention. Micrometric values of the front branches of the external carotid artery and their relations to the surrounding structures and metric data pertaining to origin locations of the superior thyroid (STA), lingual (LA), and facial (FA) arteries were evaluated in 40 samples. As regards the evaluation of the branching types of the external carotid artery, the cases where the STA, LA, and FA originated as separate branches were 90%, linguofacial trunk cases were 7.5%, and thyrolingual trunk cases were 2.5%. The diameters of the STA, LA, and FA at their origins were observed to be 3.53 +/- 1.17, 3.06 +/- 0.65, and 3.35 +/- 0.68 mm, respectively. The distances from the origin of the STA to the carotid bifurcation of 3.29 +/- 4.27 mm, origin of the STA to that of the LA of 10.45 +/- 5.16 mm, and origin of the STA to that of the FA of 18.20 +/- 8.81 mm were found. The current findings may have serious implications for radiologic examinations, exploration of the neck, thyroid and parathyroid surgery, tracheotomy, and surgery of the larynx, pharynx, upper esophagus, pterygopalatine, and infratemporal fossa.
The differences in the course and shape of the internal carotid artery (ICA) in the parapharyngeal space were investigated to determine the possible risks for serious hemorrhage during tonsillectomy, drainage of peritonsillar abscess, soft palate injuries, adenoidectomy and velopharyngeoplasty. The course of the ICA was studied in the parapharyngeal spaces of 50 adult cadavers. From each specimen, circumferential sections were obtained and they stained with hematoxylin-eosin and Verhoeff's elastic staining. The cervical course of the ICA showed no curvature in 70 cases; but in 25 cases it had a medial curve, and five cases showed kinking out of a total 100 dissected carotid sheaths. In two cases, kinking of the ICA was related to the pharyngeal wall. The histological examination of all kinking specimens demonstrated depletion and decreasing muscle tissue in tunica media and an increase was observed in vasa vasorum numbers in the tunica adventitia of ICA. The dissections and integrity losses were seen in tunica media and tunica adventitia. The vessel wall of histological structure change were detected in kinking specimens and lays the groundwork for the vessel wall to get easily harmed or torn either directly or indirectly by decreasing the elasticity and soundness of the wall. The transposition of the ICA artery in submucous position becomes important for otorhinolaryngologists when its aberrant course causes a widening in the retropharyngeal or parapharyngeal tissues and an impression on the pharyngeal wall. Curving and kinking of the ICA can constitute a risk factor for acute hemorrhage in routine surgical procedures, which are performed by inexperienced surgeons.
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