title: Surgical landmarks of the nasopharyngeal internal carotid using the maxillary swing approach: A cadaveric study.
abstract: Surgery of the paranasopharyngeal space is very hazardous due to the position of the internal carotid artery, which is surrounded by soft tissue with few anatomical landmarks.
  
  
  
  Fresh cadaveric study.
  
  
  
  In this study, we used the maxillary swing procedure to have a broad view of the internal carotid artery using an anterior approach. We sought to establish surgical landmarks, make measurements, and compare them to other imagery and cadaveric studies in the literature.
  
  
  
  We performed the maxillary swing procedure in 10 subjects (six female and four male, mean deceased age 81 years). The internal carotid artery was found to be in the same sagittal plane as the lateral pterygoid plate, the foramen ovale, and the eustachian tube isthmus. It was always located behind the stylopharyngeal fascia and immediately lateral to the longus capitis muscle. The artery was measured on average 10.7 mm from the pharyngeal recess, 7.3 mm from the eustachian tube isthmus, and 22.8 mm from the torus tubarius.
  
  
  
  The eustachian tube isthmus, the longus capitis muscle, and the stylopharyngeal fascia are the main surgical landmarks of the internal carotid artery. The artery can also be found in an oblique sagittal plane including the eustachian tube isthmus, the foramen ovale, and the lateral pterygoid plate. The pharyngeal recess remains a very dangerous area, only millimeters away from the carotid artery.
  
  
  
  NA Laryngoscope, 126:1562-1566, 2016.
authors.affiliation: Department of Otorhinolaryngology, AP-HP, Lariboisière Hospital, Paris Diderot University, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Simon
authors.affiliation: Department of Maxillofacial Surgery, AP-HP, Beaujon Hospital, Paris Diderot University, Paris, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Vacher
authors.affiliation: Department of Otorhinolaryngology, AP-HP, Lariboisière Hospital, Paris Diderot University, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Herman
authors.affiliation: Department of Otorhinolaryngology, AP-HP, Lariboisière Hospital, Paris Diderot University, Paris, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Verillaud
mesh_terms: D000369:Aged, 80 and over; D059925:Anatomic Landmarks / Q000033:anatomy & histology*; D002102:Cadaver; D002343:Carotid Artery, Internal / Q000033:anatomy & histology*; D005064:Eustachian Tube / Q000033:anatomy & histology; D005260:Female; D054085:Foramen Ovale / Q000033:anatomy & histology; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D009305:Nasopharynx / Q000033:anatomy & histology / Q000601:surgery*; D011626:Pterygoid Muscles / Q000033:anatomy & histology
keywords: Cadaveric study; eustachian tube; internal carotid artery; maxillary swing; nasopharynx