國人內頸動脈的變異及其相關因子分析

Aberrant Cervical Internal Carotid Arteries and Their Associated Factors

連景峯(Ching-Feng Lien) ； 翁旭惠(Hsu-Huei Weng) ； 劉璟鋒(Ching-Feng Liu) ； 吳泰清(Tai-Ching Wu) ； 林永松(Yung-Song Lin)

《台灣耳鼻喉頭頸外科雜誌》 47卷4期 (2012/12) Pp. 336-342

https://doi.org/10.6286/2012.47.4.336

摘要

BACKGROUND: Otolaryngologists can encounter a catastrophic hemorrhage during routine nasopharyngeal and oropharyngeal procedures such as adenoidectomies and tonsillectomies. To further understand the potential risks of the routine oropharyngeal and nasopharyngeal procedures, we analyzed the anatomic variations of the cervical internal carotid arteries (ICAs) and their associated factors such as age, gender, and anatomic side.METHODS: From February 2011 to September 2011, 233 magnetic resonance images of the brain with angiography were retrospectively collected from adult health examinations. Comparative data on cervical ICA aberrations in nasopharynx, oropharynx, and hypopharynx based on gender, anatomic side, and age were associated using Pearson chi-square and Fisher's exact analyses.RESULTS: The carotid variations in nasopharynx, oropharynx, and hypopharynx were detected in 50 (10.7%) sides, 244 (52.4%) sides, and 8 (1.7%) sides, respectively. Of the 14 (3%) sides with kinking or coiling, 3 sides of kinking and 2 (0.4%) sides of coiling were detected in nasopharynx, and 9 sides of kinking were detected in oropharynx. In the groups aged under 40 years, 41-50 years, 51-60 years, and over 61 years, oropharyngeal carotid aberrations were detected in 10 (20%) sides, 55 (39%) sides, 99 (56%) sides, and 80 (83%) sides, respectively (p ＜ 0.001).CONCLUSIONS: CONCLUSION: The most common region for cervical carotid variations is oropharynx, in which the coined term, ”dangerous loop”, might occur most frequently. The cervical carotid variations of curving, kinking, and coiling observed in this study were present in 57.7% of the images, which is within the wide range of 10-58% reported in the literature. The occurrence of oropharyngeal carotid aberrations gradually rises with increased age. To avoid catastrophic hemorrhages in routine oropharyngeal and nasopharyngeal procedures, the otolaryngologist must develop a greater understanding of the anatomic variations of the cervical ICAs and their associated factors, and must keep away from the area with strong pulsation even in superficial pharyngeal wall.

關鍵字

頸部內頸動脈 ； 內頸動脈變異 ； 危險環狀

並列摘要

BACKGROUND: Otolaryngologists can encounter a catastrophic hemorrhage during routine nasopharyngeal and oropharyngeal procedures such as adenoidectomies and tonsillectomies. To further understand the potential risks of the routine oropharyngeal and nasopharyngeal procedures, we analyzed the anatomic variations of the cervical internal carotid arteries (ICAs) and their associated factors such as age, gender, and anatomic side.METHODS: From February 2011 to September 2011, 233 magnetic resonance images of the brain with angiography were retrospectively collected from adult health examinations. Comparative data on cervical ICA aberrations in nasopharynx, oropharynx, and hypopharynx based on gender, anatomic side, and age were associated using Pearson chi-square and Fisher's exact analyses.RESULTS: The carotid variations in nasopharynx, oropharynx, and hypopharynx were detected in 50 (10.7%) sides, 244 (52.4%) sides, and 8 (1.7%) sides, respectively. Of the 14 (3%) sides with kinking or coiling, 3 sides of kinking and 2 (0.4%) sides of coiling were detected in nasopharynx, and 9 sides of kinking were detected in oropharynx. In the groups aged under 40 years, 41-50 years, 51-60 years, and over 61 years, oropharyngeal carotid aberrations were detected in 10 (20%) sides, 55 (39%) sides, 99 (56%) sides, and 80 (83%) sides, respectively (p ＜ 0.001).CONCLUSIONS: CONCLUSION: The most common region for cervical carotid variations is oropharynx, in which the coined term, ”dangerous loop”, might occur most frequently. The cervical carotid variations of curving, kinking, and coiling observed in this study were present in 57.7% of the images, which is within the wide range of 10-58% reported in the literature. The occurrence of oropharyngeal carotid aberrations gradually rises with increased age. To avoid catastrophic hemorrhages in routine oropharyngeal and nasopharyngeal procedures, the otolaryngologist must develop a greater understanding of the anatomic variations of the cervical ICAs and their associated factors, and must keep away from the area with strong pulsation even in superficial pharyngeal wall.

並列關鍵字

cervical internal carotid artery ； aberrant internal carotid artery ； dangerous loop