Minimally invasive surgical exposure of the extreme high cervical internal carotid artery: anatomical study

Kiya, Nobuo; Sawamura, Yutaka; Dureza, Catalino; Fukushima, Takanori

doi:10.1054/jocn.1999.0241

Cited by 9 publications

(18 citation statements)

References 21 publications

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“…The first stage comprised reading of titles and abstracts, which resulted in selection of 80 articles and the second stage comprised reading of the full texts of articles for which they were available, resulting in inclusion of 57 articles in the review. Nine of these were experimental, 7 - 14 47 were clinical studies (case reports and series), 3 , 15 - 57 and one 6 was a clinical and experimental study. The total sample included 101 specimens (cadaveric carotid arteries dissected) and 480 patients (see Tables S1 and S2, available online as a supplementary file), and the most frequent indications for exposure of DCSICA or HCB were stenosis due to atheromatosis and aneurysms (see Table S2, available online as a supplementary file).…”

Section: Resultsmentioning

confidence: 99%

“…It should be noted that it is possible to enlarge exposure of the ICA with some variations of the conventional technique, such as section/deinsertion of the SCM muscle at the level of the mastoid process, 7 , 8 , 18 followed by retraction 30 , 31 , 51 or use of a Thompson retractor, 54 that enables vascular control 1 cm from the base of the skull.…”

Section: Discussionmentioning

confidence: 99%

“… 5 An important anatomic landmark for the accessory nerve (XI pair) is its lateral point, located around 3 to 15 mm below and to the side of the anterior border of the transverse process of the atlas. 7 Additionally, medial dissection of the ICA at this level can injure the superior laryngeal nerve, causing dysphagia and dysphonia.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Acesso cirúrgico ao segmento cervical distal da artéria carótida interna e à bifurcação carotídea alta – revisão integrativa da literatura e proposta de protocolo

et al. 2022

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Resumo Diversas manobras já foram descritas para o acesso ao segmento distal cervical da artéria carótida interna ou à bifurcação carotídea alta; entretanto, há divergências na sistematização dessas técnicas. O objetivo deste estudo é revisar as técnicas descritas e propor um protocolo prático que auxilie na seleção da técnica mais adequada para cada caso. Para isso, foi realizada uma busca nas bases de dados PubMed Central, Biblioteca Virtual em Saúde e SciELO por artigos sobre o tema, em língua inglesa ou portuguesa, publicados entre os anos de 1980 e 2021. Entre as manobras descritas, parece razoável que as duas etapas iniciais sejam a abordagem ao músculo esternocleidomastóideo, seguida pela secção/retração do ventre posterior do músculo digástrico. Caso necessário, a subluxação mandibular temporária unilateral é um recurso adicional e preferível à divisão do aparato estiloide, devido ao menor potencial de morbidade. Exposições ainda mais amplas podem ser obtidas com as osteotomias mandibulares.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Acesso cirúrgico ao segmento cervical distal da artéria carótida interna e à bifurcação carotídea alta – revisão integrativa da literatura e proposta de protocolo

et al. 2022

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“…The GPN surrounds the external side of the stylopharyngeus muscle to reach its anterior surface inside the pyramid [ 11 ]. In this course, the GPN provides motor innervation to the muscle [ 14 , 25 , 26 ]. Once within the pyramid, the most common position of the GPN is in a triangle, in which the posterior margin is the external carotid artery, the lower one is the facial artery and the anterior one is the styloglossus muscle [ 27 ] (Fig.…”

Section: Cross-sectional Anatomymentioning

confidence: 99%

“…Once in the pharynx, the GPN splits into pharyngeal branches, which contribute to the pharyngeal plexus of the vagus, and the lingual branch [ 4 , 6 , 10 , 14 , 25 ]. The references of the lingual branch are the lower edge of the palatine tonsil (palatoglossus and styloglossus muscles) and the hyoglossus muscle.…”

Section: Cross-sectional Anatomymentioning

confidence: 99%

Tracking the glossopharyngeal nerve pathway through anatomical references in cross-sectional imaging techniques: a pictorial review

et al. 2018

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The glossopharyngeal nerve (GPN) is a rarely considered cranial nerve in imaging interpretation, mainly because clinical signs may remain unnoticed, but also due to its complex anatomy and inconspicuousness in conventional cross-sectional imaging. In this pictorial review, we aim to conduct a comprehensive review of the GPN anatomy from its origin in the central nervous system to peripheral target organs. Because the nerve cannot be visualised with conventional imaging examinations for most of its course, we will focus on the most relevant anatomical references along the entire GPN pathway, which will be divided into the brain stem, cisternal, cranial base (to which we will add the parasympathetic pathway leaving the main trunk of the GPN at the cranial base) and cervical segments. For that purpose, we will take advantage of cadaveric slices and dissections, our own developed drawings and schemes, and computed tomography (CT) and magnetic resonance imaging (MRI) cross-sectional images from our hospital’s radiological information system and picture and archiving communication system.Teaching Points• The glossopharyngeal nerve is one of the most hidden cranial nerves.• It conveys sensory, visceral, taste, parasympathetic and motor information.• Radiologists’ knowledge must go beyond the limitations of conventional imaging techniques.• The nerve’s pathway involves the brain stem, cisternal, skull base and cervical segments.• Systematising anatomical references will help with nerve pathway tracking.

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Petrous Carotid Artery’s In Situ Bypass: Anatomic Study

Keshelava¹,

Mikadze²,

Abzianidze³

et al. 2008

World j. surg.

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The purpose of our study was to reveal the possibility of cervical-to-petrous carotid artery in situ bypass with maximum preservation of cranial nerves. Four human cadavers prepared in formalin were investigated. Eight surgical approaches were used (bilateral exposure on each cadaver). The skin incision started from the level of the temporomandibular joint. The VII, IX, X, and XII cranial nerves, starting from the stylomastoid angle, were maximally preserved. Resection of the styloid process, subluxation of the mandibular joint, and milling of tympanic bone revealed the petrous carotid artery. Exposure of the carotid bifurcation was performed with a mini-skin incision. After dividing the petrous internal carotid artery (ICA) and the cervical ICA, the cervical ICA was dilated using a Fogarty catheter to simulate aneurysmal dilatation. The patient's saphenous vein after stripping was utilized for the bypass. The vein was passed into the lumen of the dilated cervical ICA, and a cervical-to-petrous carotid bypass was performed. In each case, the described technique made it possible to expose the intrapetrous carotid artery adequately. In two cases it was impossible to make a luxation, and therefore the mandibular branch was resected. The vertical segment's mean length was 12 mm (range 10-15 mm). In all cases, the VII, IX, X, and XII cranial nerves were preserved maximally. The main points of the approach are luxation of the mandibular articulation and milling of the tympanic bone. Our study in cadavers suggests the possibility of petrous carotid artery bypass without exposing the cervical ICA.

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Minimally invasive surgical exposure of the extreme high cervical internal carotid artery: anatomical study

Cited by 9 publications

References 21 publications

Acesso cirúrgico ao segmento cervical distal da artéria carótida interna e à bifurcação carotídea alta – revisão integrativa da literatura e proposta de protocolo

Acesso cirúrgico ao segmento cervical distal da artéria carótida interna e à bifurcação carotídea alta – revisão integrativa da literatura e proposta de protocolo

Tracking the glossopharyngeal nerve pathway through anatomical references in cross-sectional imaging techniques: a pictorial review

Petrous Carotid Artery’s In Situ Bypass: Anatomic Study

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