Rare case of double looped ansa cervicalis associated with its deep position in the carotid triangle of the neck

Abstract

Ansa cervicalis (AC) frequently shows its variations in the formation and distribution pattern. However, variation in its looping pattern associated with abnormal topographic disposition is relatively rare. Knowledge on the possible deviations in the looping pattern is clinically important, to avoid iatrogenic injuries in surgical procedures. We report here a concurrent rare case of double looped AC located deep to internal jugular vein. Anatomy of its superior root was normal, but the usual appearance of inferior root had gone astray due to formation of double loop. AC is being popularly used for nerve reconstructive surgery in treating paralyzed larynx, tongue hemiatrophy. Anatomical variation of it may potentially jeopardize the surgical procedures. Therefore, it is essential to the surgeons to be familiar with its unusual variations.

Ansa cervicalis: a comprehensive review of its anatomy, variations, pathology, and surgical applications

“…The superior root branches from the hypoglossal component to form a loop with the inferior root from the cervical component. Type III has double loops and is composed of the hypoglosso-cervical ansa and vagocervical ansa (hypoglosso-vagocervical ansa) [232425]. Type IV has the hypoglossal component but forms a loop with the vagal and cervical components (vagocervical ansa) [2526272829].…”