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Origin variations of the superior thyroid, lingual, and facial arteries: a computed tomography angiography study

  • Anatomic Variations
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Abstract

Purpose

To determine the anatomical variations and morphology of the external carotid artery (ECA) and its anterior branches.

Methods

Using computed tomography angiography (CTA), the origin, internal diameter, and surface laterality emergence of the superior thyroid (STA), lingual (LA), and facial (FA) arteries were evaluated retrospectively evaluated and classified. The bifurcation level of the common carotid artery (CCA) in relation to the cervical vertebrae and disc was also determined.

Results

A total of 76 CTA were included in the study. STA originated from the carotid bifurcation (CB) (type I), CCA (type II) and ECA (type III) in 20.4 (31/152), 17.1 (26/152) and 50.7% (77/152) cases, respectively. Also 10.5% (16/152) arose from a shared trunk with LA as a thyrolingual trunk (TLT) (type IVa), and absent in 1.3% (2/152). LA originated in the CB in only one case. A linguofacial trunk (LFT) was present in 14.5% (22/152). Mean diameters of STA, LA and FA were 1.70, 1.95 and 2.45 mm, respectively. Meanwhile, surface laterality were predominately from anteromedial, medial, and anterior, respectively. CB was mainly on C3 or C3–C4 (55.9% of cases).

Conclusions

STA origin below the ECA is a common finding. Our population presented the highest percentage of TLT (10.5%) and high CB (9.8%) in literature. Considering these variations are important to prevent complications in neck surgical procedures.

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References

  1. Acar M, Salbacak A, Sakarya ME, Zararsiz I, Ulusoy M (2013) The morphometrical analysis of the external carotid artery and its branches with multidetector computerized tomography angiography technique. Int J Morphol 31(4):1407–1414. https://doi.org/10.4067/S0717-95022013000400042

    Article  Google Scholar 

  2. Adachi B (1928) Das Arteriensystem der Japaner, vol 2. Maruzen, Kyoto, pp 196–242

    Google Scholar 

  3. Bliss RD, Gauger PG, Delbridge LW (2000) Surgeon's approach to the thyroid gland: surgical anatomy and the importance of technique. W J Surg 24:891–897. https://doi.org/10.1007/s002680010173

    Article  CAS  Google Scholar 

  4. Cappabianca S, Scuotto A, Iaselli F (2012) Computed tomography and magnetic resonance angiography in the evaluation of aberrant origin of the external carotid artery branches. Surg Radiol Anat 34:393–399. https://doi.org/10.1007/s00276-011-0926-3

    Article  PubMed  Google Scholar 

  5. Dessie MA (2018) Variations of the origin of superior thyroid artery and its relationship with the external branch of superior laryngeal nerve. PLoS ONE 13(5):e0197075. https://doi.org/10.1371/journal.pone.0197075

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Esen K, Ozgur A, Balci Y, Tok S, Kara E (2017) Variations in the origins of the thyroid arteries on CT angiography. Jpn J Radiol 36(2):96–102. https://doi.org/10.1007/s11604-017-0710-3

    Article  CAS  PubMed  Google Scholar 

  7. Gluncic V, Petanjek Z, Marusic A, Gluncic I (2001) High bifurcation of common carotid artery, anomalous origin of ascending pharyngeal artery and anomalous branching pattern of external carotid artery. Surg Radiol Anat 23(2):123–125. https://doi.org/10.1007/s00276-001-0123-x

    Article  CAS  PubMed  Google Scholar 

  8. Gupta P, Bhalla AS, Thulkar S (2014) Variations in superior thyroid artery: a selective angiographic study. Indian J Radiol Imaging 24(1):66–71. https://doi.org/10.4103/0971-3026.130701

    Article  PubMed  PubMed Central  Google Scholar 

  9. Hayashi N, Hori E, Ohtani Y (2005) Surgical anatomy of the cervical carotid artery for carotid endarterectomy. Neurol Med Chir 45:25–30

    Article  Google Scholar 

  10. Inabnet WB III, Jacob BP, Gagner M (2003) Minimally invasive endoscopic thyroidectomy by a cervical approach. Surg Endosc 17:1808–1811. https://doi.org/10.1007/s00464-002-8760-7

    Article  PubMed  Google Scholar 

  11. Itezerote AM, Rodrigues CFS, Prates JC (1999) Arteria tiroidea superior: origen, ramas colaterales y glandulares. Rev Chil Anat 17(1):47–50. https://doi.org/10.4067/S0716-98681999000100007

    Article  Google Scholar 

  12. Jeganath V, McElwaine JG, Stewart P (2001) Ruptured superior thyroid artery from central vein cannulation: treatment by coil embolization. Brit J Anaesth 87(2):302–305. https://doi.org/10.1093/bja/87.2.302

    Article  CAS  PubMed  Google Scholar 

  13. Klosek SK, Rungruang T (2008) Topography of carotid bifurcation: considerations for neck examination. Surg Radiol Anat 30(5):383–387. https://doi.org/10.1007/s00276-008-0337-2

    Article  PubMed  Google Scholar 

  14. Kramer M, Vairaktaris E, Nkenke E, Schlegel KA, Neukam FW, Lell M (2008) Vascular map** of head and neck: computed tomography angiography versus digital subtraction angiography. J Oral Maxillofac Surg 66(2):302–307. https://doi.org/10.1016/j.joms.2007.05.031

    Article  PubMed  Google Scholar 

  15. Krmpotic-Nemanic J, Draf W, Helms J (2012) Surgical anatomy of head and neck. Springer Science and Business Media, Berlin

    Google Scholar 

  16. Lemaire V, Jacquemin G, Medot M, Fissette J (2001) Thyrolingual trunk arising from common carotid artery—a case report. Surg Radiol Anat 23:135–137. https://doi.org/10.7860/JCDR/2017/23144.10365

    Article  CAS  PubMed  Google Scholar 

  17. Lippert H, Pabst R (1985) Arterial variations in man. JF Bergmann Verlag, München, pp 62–65

    Book  Google Scholar 

  18. Lo A (2006) Anatomical variations of the common carotid bifurcation. ANZ J Surg 76:970–972. https://doi.org/10.1111/j.1445-2197.2006.03913.x

    Article  PubMed  Google Scholar 

  19. Lucev N, Bobinac D, Maric I, Drescik I (2000) Variations of the great arteries in the carotid triangle. Otolaryngol Head Neck Surg 122(4):590–591. https://doi.org/10.1067/mhn.2000.97982

    Article  CAS  PubMed  Google Scholar 

  20. Manjunath CS, Lokanathan TH (2016) Anatomical variations in the origin of superior thyroid artery and its clinical significance. Int J Anat Res 4(3):2656–2658. https://doi.org/10.16965/ijar.2016.295

    Article  Google Scholar 

  21. Mata JR, Mata FR, Souza MCR, Nishijo H, Ferreira TAA (2012) Arrangement and prevalence of branches in the external carotid artery in humans. Ital J Anat Embryol 117(2):65–74

    PubMed  Google Scholar 

  22. Michalinos A, Chatzimarkos M, Arkadopoulos N, Safioleas M, Troupis T (2016) Anatomical considerations on surgical anatomy of the carotid bifurcation. Anat Res Int 2016:6907472. https://doi.org/10.1155/2016/6907472

    Article  PubMed  PubMed Central  Google Scholar 

  23. Narayanan S, Murugan S (2018) Association of high carotid bifurcation and thyrolinguofacial trunk: a rare variation. Anat Sci Int 93(2):307–310. https://doi.org/10.1007/s12565-017-0405-y

    Article  CAS  PubMed  Google Scholar 

  24. Natsis K, Raikos A, Foundos I (2011) Superior thyroid artery origin in Caucasian Greeks : a new classification proposal and review of the literature. Clin Anat 24(6):699–705. https://doi.org/10.1002/ca.21181

    Article  PubMed  Google Scholar 

  25. Nochikattil SK, Sajith Babu TP, Manoharan S (2017) Thyrolingual trunk arising from common carotid artery—a case report. J Clin Diagn Res 11(8):AD01–AD02. https://doi.org/10.7860/JCDR/2017/23144.10365

    Article  PubMed  PubMed Central  Google Scholar 

  26. Nomura M, Mori K, Seki S (2015) Perforation of superior thyroid artery by guidewire during carotid artery stenting. Neuroradiol J 28(3):329–332. https://doi.org/10.1177/1971400915594928

    Article  PubMed  PubMed Central  Google Scholar 

  27. OngetiOgeng’O KWJA (2011) Variant origin of the superior thyroid artery in a Kenyan population. Clin Anat 25(2):198–202. https://doi.org/10.1002/ca.21207

    Article  Google Scholar 

  28. Ozgur Z, Govsa F, Celik S, Ozgur T (2009) Clinically relevant variations of the superior thyroid artery: an anatomic guide for surgical neck dissection. Surg Radiol Anat 31(3):151. https://doi.org/10.1007/s00276-008-0405-7

    Article  PubMed  Google Scholar 

  29. Ozgur Z, Govsa F, Ozgur T (2008) Anatomic study assessment of origin characteristics of the front branches of the external carotid artery. J Craniofac Surg 19(4):1159–1166

    Article  Google Scholar 

  30. Quain R (1844) Anatomy of the arteries of the human body. Taylor & Walton, London, pp 538–543

    Google Scholar 

  31. Shintani S, Terakado N, Alcalde R, Tomizawa K, Nakayama S, Ueyama Y, Ichikawa H, Sugimoto T, Matsumura T (1999) An anatomical study of the arteries for intraarterial chemotherapy of head and neck cancer. Int J Clin Oncol 4:327–330. https://doi.org/10.1007/s101470050079

    Article  Google Scholar 

  32. Sreedhan R, Krishna L, Shetty A (2018) Origin of superior thyroid artery: under the surgeon’s knife. J Vasc Bras 17(4):290–295

    Article  Google Scholar 

  33. Terayama N, Sanada J, Matsui O, Kobayashi S, Kawashima H, Yamashiro M et al (2006) Feeding artery of laryngeal and hypopharyngeal cancers: role of the superior thyroid artery in superselective intraarterial chemotherapy. Cardiovasc Inter Rad 29(4):536–543. https://doi.org/10.1007/s00270-005-0094-0

    Article  Google Scholar 

  34. Tubbs SR, Shoja M, Loukas M (2016) Bergman's comprehensive encyclopedia of human anatomic variation, 1st edn. Wiley-Blackwell, Malden, p 522

    Book  Google Scholar 

  35. Vázquez T, Cobiella R, Maranillo E, Valderrama FJ, Mchanwell S, Parkin I, San JR (2009) Anatomical variations of the superior thyroid and superior laryngeal arteries. Head Neck 31(8):1078–1085. https://doi.org/10.1002/hed

    Article  PubMed  Google Scholar 

  36. Wilson JL, Rozen WM, Ross R, Findlay MW, Ashton MW, Behan FC (2012) The superior thyroid artery perforator flap: anatomical study and clinical series. Plast Reconstr Surg 129(3):641–646. https://doi.org/10.1097/PRS.0b013e3182402eb2

    Article  CAS  PubMed  Google Scholar 

  37. Won S (2016) Anatomical considerations of the superior thyroid artery: its origins, variations, and position relative to the hyoid bone and thyroid cartilage. Anat Cell Biol 49:138–142

    Article  Google Scholar 

  38. Yonenaga K, Tohnai I, Mitsudo K, Mori Y, Saijo H, Iwai T, Yonehara Y, Ota Y, Torigoe K, Takato T (2011) Anatomical study of the external carotid artery and its branches for administration of superselective intra-arterial chemotherapy via the superficial temporal artery. Int J Clin Oncol 16:654–659

    Article  Google Scholar 

  39. Yu NH, Jahng TA, Kim CH, Chung CK (2010) Life-threatening late hemorrhage due to superior thyroid artery dissection after anterior cervical discectomy and fusion. Spine 35(15):E739–E742. https://doi.org/10.1097/BRS.0b013e3181cf46b4

    Article  PubMed  Google Scholar 

  40. Zümre O, Salbacak A, Ciçekcibaşi AE, Tuncer I, Seker M (2005) Investigation of the bifurcation level of the common carotid artery and variations of the branches of the external carotid artery in human fetuses. Ann Anat 187:361–369. https://doi.org/10.1016/j.aanat.2005.03.007

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Departamento de Anatomía Humana, Facultad de Medicina, Universidad Autónoma de Nuevo León, Francisco I. Madero and Aguirre Pequeño Sin Numero, Colonia Mitras Centro Monterrey, 64460, Nuevo León, Mexico

    Mario Herrera-Núñez, Alejandro Quiroga-Garza, Bernardo Alfonso Fernandez-Rodarte, Rodrigo Enrique Elizondo-Omaña & Santos Guzmán-López

  2. University Hospital “Dr. Jose E. Gonzalez” Radiology and Diagnostic Imaging Department, Universidad Autonoma de Nuevo Leon, Nuevo León, Mexico

    José Luis Menchaca-Gutiérrez, Ricardo Pinales-Razo & Guillermo Elizondo-Riojas

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  1. Mario Herrera-Núñez
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Contributions

MH-N: Idea development, Protocol/project development, Submission to Committees, Data collection and management, Data analysis, Manuscript writing, manuscript editing. JLM-G: Protocol/project development, Data collection and management, Data analysis, Manuscript writing. RP-R: Protocol/project development, Data collection and management, Data analysis, Manuscript writing. GE-R: Protocol/project development, Submission to Committees, Data analysis, manuscript editing. AQ-G: Idea development, Protocol/project development, Submission to Committees, Data collection and management, Data analysis, Manuscript writing, manuscript editing. BAF-R: Idea development, Protocol/project development, Data analysis, Manuscript writing. REE-O: Idea development, Protocol/project development, Data analysis, Manuscript editing. SG-L: Idea development, Protocol/project development, Data analysis, Manuscript editing.

Corresponding author

Correspondence to Alejandro Quiroga-Garza.

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Herrera-Núñez, M., Menchaca-Gutiérrez, J.L., Pinales-Razo, R. et al. Origin variations of the superior thyroid, lingual, and facial arteries: a computed tomography angiography study. Surg Radiol Anat 42, 1085–1093 (2020). https://doi.org/10.1007/s00276-020-02507-6

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