Effect of carotid artery aberrancy on the distance between the vessel and nasopharyngeal subsites.
BACKGROUND
Life-threatening hemorrhaging due to nasopharyngeal internal carotid artery (ICA) aberrancy may occur during routine nasopharyngeal surgery. To understand better the potential adverse effect of nasopharyngeal ICA aberrancy on routine nasopharyngeal surgery, we classified aberrant nasopharyngeal ICAs and analyzed the differences in mean distances from the ICA to nasopharyngeal subsites between aberrant and nonaberrant vessels.


METHODS
The courses of nasopharyngeal ICAs were examined and classified for an aberrant pathway. Various distances were measured on magnetic resonance brain scans. The mean values of the measured variables were compared using an unpaired two-sample t test.


RESULTS
The mean distances to the torus tubarius, the opening of Rosenmuller's fossa, and the posterior nasopharyngeal wall were 19.6 mm, 15.8 mm, and 16.7 mm, respectively, in the aberrant case group, and 23.1 mm (p < 0.001), 19.8 mm (p < 0.001), and 20.7 mm (p < 0.001) in the nonaberrant control group.


CONCLUSIONS
The mean distances between the ICA and nasopharyngeal subsites were significantly shortened (by 15-21%) in the presence of aberrant nasopharyngeal segments, which may increase the risk of severe complications in common and uncomplicated nasopharyngeal surgery, such as adenoidectomy, eustachian tuboplasty, and nasopharyngeal biopsies. However, the mean distances were not shortened by the severity (kinking and coiling) of the aberrant nasopharyngeal carotid arteries.
Department of Otolaryngology, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan, ROC.
Ching-Feng
CF
Lien
Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi and Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
Hsu-Huei
HH
Weng
Institute of Imaging and Biomedical Photonics, National Chiao Tung University, Tainan, Taiwan, ROC.
Bor-Shyh
BS
Lin
Department of Otolaryngology, Chi Mei Medical Center, Tainan, Taiwan, ROC; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan, ROC. Electronic address: wtcen@hotmail.com.
Ching-Feng
CF
Liu
Department of Diagnostic Radiology, Chi Mei Medical Center, Tainan, Taiwan, ROC.
Tai-Ching
TC
Wu
Department of Otolaryngology, Chi Mei Medical Center, Tainan, Taiwan, ROC.
Yung-Song
YS
Lin
D000328:Adult; D000368:Aged; D002343:Carotid Artery, Internal / Q000002:abnormalities* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies
aberrant internal carotid artery; cervical internal carotid artery; nasopharyngeal surgery; vascular anomaly