Abnormal Course of Internal Carotid Artery Encountered During Neck Dissection

Significant tortuosity of the internal carotid artery encountered during neck dissection

“…The CCA bifurcates into the external carotid artery and ICA at the upper end of the thyroid cartilage (approximately at the level of the fourth cervical vertebra). 4 Although the ICA typically runs a straight course, this is not always the case, as variations can occur. The estimated prevalence of an abnormal course or geometry of the ICA ranges from 4% to 25%.…”

“…Chamania et al emphasized that during an ND, meandering of the capsulated ICA can mimic lymph nodes at level IIb; therefore, absolute care is required during its dissection to avoid any inadvertent damage. 4 Frequent palpation to confirm pulsation is recommended when detaching the tissue at levels IIa and IIb. 13 In the present case, we initially identified the protuberance where the ICA was expected to be located.…”

“…It is crucial that surgeons performing NDs must possess thorough knowledge regarding the course of the ICA to avoid fatal complications. The CCA bifurcates into the external carotid artery and ICA at the upper end of the thyroid cartilage (approximately at the level of the fourth cervical vertebra) 4 . Although the ICA typically runs a straight course, this is not always the case, as variations can occur.…”

“…1,2 The ICA may exhibit significant tortuosity, which may lead to severe complications during surgery; however, only few reports have emphasized the need for caution during an ND. [1][2][3][4] In this report, we presented a rare case of significant tortuosity of the ICA encountered during an ND, and we reviewed previous reports regarding this anomaly.…”