Internal Carotid Stenosis Associated with Compression by Hyoid Bone

Martinelli, Ombretta; Fresilli, Mauro; Jabbour, Jihad; Girolamo, Alessia Di; Irace, Francesco Giosuè

doi:10.1016/j.avsg.2018.09.043

Cited by 12 publications

(9 citation statements)

References 7 publications

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“…In that case, the carotid–hyoid relationships were type XI on the right and type VI on the left [ 20 ]. Martinelli et al (2019) identified a type XI carotid–hyoid relationship in one case [ 22 ]. A type XI relationship was found in one case by Liu et al (2020), with the tip of the greater hyoid horn between the ECA (laterally) and ICA (medially) pressing on the carotid sinus or bulb [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

The Carotid–Hyoid Topography Is Variable

Manta,

Rusu,

Hostiuc

et al. 2023

Medicina

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Background and Objectives: The carotid bifurcation (CB) is presented in most anatomy textbooks as having a unique location at the upper margin of the thyroid cartilage. Although a number of case reports have provided evidence of the possibility of carotid artery location either lateral or medial to the greater hyoid horn, these reports have not established specific anatomic possibilities and prevalences. Materials and Methods: We retrospectively analysed a batch of 147 CT angiograms for 12 types of carotid–hyoid relationships and classified the bilateral combination possibilities of these types. Results: In 168/294 sides there were no carotid–hyoid relationships. Type I, external carotid artery (ECA) medial to the greater horn of the hyoid bone (GHHB), was observed in 0.34%; type II, internal carotid artery (ICA) medial to GHHB, in 0.34%; type III, ICA and ECA medial to GHHB, in 1.02%; type IV, common carotid artery (CCA) medial to GHHB, in 1.02%; type V, CB medial to GHHB, in 0.34%; type VI, ECA lateral to GHHB, in 20.41%; type VII, ICA lateral to GHHB, was not recorded; type VIII, ECA and ICA lateral to GHHB, in 3.74%; type IX, CCA lateral to GHHB, in 8.5%; type X, CB lateral to GHHB, in 6.46%; type XI, ECA lateral and ICA medial to GHHB, in 0.34%; and type XII, ICA lateral and ECA medial to GHHB, in 0.34%. Bilateral symmetry was found in 70.74% of cases, including the null types without carotid–hyoid relationships as well as types IV, VI, VIII, IX, and X. There was a highly significant association between the left and right variants of the carotid–hyoid relationship. Conclusions: Mechanical compression of the hyoid bone on the carotid arteries has various undesirable effects on the ICA and cerebral circulation. Underlying these are several variational anatomical patterns of carotid–hyoid relationships, which can be accurately documented on CT angiograms. A case-by-case anatomical study is better than assuming the carotid anatomy learned from textbooks.

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Section: Discussionmentioning

confidence: 99%

The Carotid–Hyoid Topography Is Variable

Manta,

Rusu,

Hostiuc

et al. 2023

Medicina

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“…The present study was designed to determine a possible association between the occurrence of ECACs and anomalous position of the hyoid bone by means of posterior tilting of the greater horns. Such association could be established based on the previous findings which suggest adjacent bony structures in the cervical region may interfere with carotid arteries (12)(13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

“…Cerebrovascular accidents correlated with mechanical interference between cervical structures and carotid arteries have been reported in the literature (9)(10)(11). There also have been some papers describing the impingement or compression of the internal carotid arteries by hyoid bone and trauma caused by the greater horn of the hyoid bone resulting in stenosis or traumatic pseudoaneurysm of the carotid arteries (12)(13)(14). In a recent report, a case of hyoid bone compressing the carotid artery with its right greater horn tilted posteriorly has been described (15).…”

Section: Introductionmentioning

confidence: 99%

Assessment of posterior tilting of the hyoid bone in relation to carotid atherosclerosis: a CBCT study

Koç

2022

Journal of Health Sciences and Medicine

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Aim: The present study aimed to investigate whether the presence and areal and volumetric measurements of the unilateral extra-cranial carotid artery calcifications (ECACs) are associated with posterior tilting of the hyoid bone. Material and Method: A total of 658 cone-beam computed tomography (CBCT) scans were screened for the presence of ECACs. The calcifications were categorized as unilateral (right or left) or bilateral. Study group was consisted of cases with unilateral ECACs. A control group without ECACs matching with study group by age and gender was created. Volumetric and areal measurements in the ECAC group were done by using Mimics Medical software. Posterior tilting of the hyoid bone in relation to mid-sagittal plane and the dimension of posterior inclination through the greater horns were measured on i-Cat Vision software. Results: In total, 71 (10.8%) ECACs (30 bilateral and 41 unilateral) were detected. Study group consisted of 41 (6.2%) unilateral ECAC cases [25 (61%) females and 16 (39%) males]. Gender and age distributions were similar between ECAC and control groups. No significant difference between two groups was found considering the prevalence of posterior tilting of the hyoid bone (63.4% vs. 43.9%, p=0.240). Similarly, there was no significant difference in the mean dimension of posterior inclination between groups (2.48±2.12 mm. vs. 2.24±1.47 mm, p=0.646). The volume and areal measurements of calcifications were not correlated with the dimension of posterior inclination of the hyoid bone. Conclusion: Posterior tilting of the hyoid bone may be a frequent finding in cases of unilateral ECAC. However, the present findings suggest that no significant relationship exists between the presence of unilateral ECACs and posterior tilting of the hyoid bone.

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“…10) We found that 17 ACVS cases due to HB obstruction have been reported previously. Among these reports, we summarized cases in which we identified the running course of the ICA (medial or lateral to ECA) and the positional relationship between HB and ICA 1,[11][12][13][14][15][16][17][18][19][20][21][22] (Table 1). Among 14 cases, seven cases had twisted carotid bifurcations, and in all the cases the greater horn of HB was located lateral to the ICA.…”

Section: Nmc Case Report Journal Vol 8 2021mentioning

confidence: 99%

Carotid Endarterectomy Requiring Removal of the Superior Horn of Thyroid Cartilage: Case Report and Literature Review

Ishikawa

Moribe

Ito

et al. 2021

NMC Case Report Journal

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Carotid endarterectomy (CEA) is an established surgical procedure for carotid stenosis. We present the case of a 74-year-old man who underwent CEA for symptomatic internal carotid artery (ICA) stenosis. During the operation, we found that the hyoid bone (HB) and the superior horn of the thyroid cartilage covered the carotid sheath, preventing adequate visualization. Since this was anticipated based on preoperative examinations, the superior horn of thyroid cartilage was removed with the help of an otorhinolaryngologist. The HB was preserved because it could be retracted, and thereafter we performed CEA. Although CEA is a common procedure, the HB and thyroid cartilage are rarely involved in the operation. We present a case report including literature review of acute cerebrovascular syndrome (ACVS) due to HB and thyroid cartilage obstruction.

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Internal Carotid Stenosis Associated with Compression by Hyoid Bone

Cited by 12 publications

References 7 publications

The Carotid–Hyoid Topography Is Variable

The Carotid–Hyoid Topography Is Variable

Assessment of posterior tilting of the hyoid bone in relation to carotid atherosclerosis: a CBCT study

Carotid Endarterectomy Requiring Removal of the Superior Horn of Thyroid Cartilage: Case Report and Literature Review

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