title: Internal carotid artery variations in velocardiofacial syndrome patients and its implications for surgery.
abstract: BACKGROUND
  Medially displaced internal carotid arteries in velocardiofacial syndrome carry a risk during pharyngeal flap surgery. This study was designed to evaluate the frequency of medially deviated internal carotid arteries in both velocardiofacial syndrome patients and the general pediatric population and to assess the minimum distance to the pharyngeal walls to define the potential risk of internal carotid artery injury during pharyngeal surgery.
  
  
  METHODS
  Twenty-three consecutive patients with velocardiofacial syndrome who underwent posterior pharyngeal flap surgery and 21 control subjects who did not have velocardiofacial syndrome but who underwent oropharynx magnetic resonance imaging were reviewed.
  
  
  RESULTS
  Medial deviation of at least one internal carotid artery was documented in 10 velocardiofacial syndrome patients (43.5 percent), compared with three patients (14.3 percent) in the control group (p=0.034). The mean±SD minimum distance to the posterior pharyngeal wall was 3.78±1.86 mm in velocardiofacial syndrome patients and 9.17±2.94 mm in the control group (p=0.014). Only one patient had significant medial dislocation of the internal carotid artery, and the closest distance from the pharyngeal wall was 0.86 mm.
  
  
  CONCLUSIONS
  In velocardiofacial syndrome patients, medial dislocation of the internal carotid artery was common, and the minimum distance to the pharyngeal wall was short compared with the control group. However, in most of the authors' patients, the course of the cervical portion of the internal carotid artery is irrelevant to pharyngeal flap surgery. The authors conclude that preoperative vascular imaging study is not cost-effective in velocardiofacial syndrome patients but that intraoperative use of ultrasound imaging is still valuable for the purpose of planning pharyngeal flap surgery.
  
  
  METHODS
  Risk, II.
authors: Seongnam, Gyeonggi, Republic of Korea From the Departments of Plastic Surgery and Radiology, Seoul National University Bundang Hospital; and the Seoul National University College of Medicine.
authors: Rong-Min
authors: RM
authors: Baek
authors: Youn-Taek
authors: YT
authors: Koo
authors: Soo-Jin
authors: SJ
authors: Kim
authors: Ji-Hoon
authors: JH
authors: Kim
authors: Ji-Young
authors: JY
authors: Kim
authors: Baek-Kyu
authors: BK
authors: Kim
mesh_terms: D000293:Adolescent; D002343:Carotid Artery, Internal / Q000002:abnormalities* / Q000601:surgery; D002648:Child; D004062:DiGeorge Syndrome / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010614:Pharynx / Q000601:surgery; D013524:Surgical Flaps; D054079:Vascular Malformations / Q000175:diagnosis* / Q000601:surgery; D057772:Vascular System Injuries / Q000209:etiology / Q000517:prevention & control*
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