Cadaveric and angiographic studies of superior thyroid artery: anatomical variations in origin and distance to carotid bifurcation.

Main Article Content

Pattama Amarttayakong
Worawut Woraputtaporn
Waranon Munkong
Sukrit Sangkhano

Abstract

This study aims to analyze the incidence of variations in the origin of the superior thyroid artery (STA) in Thai people and the vertical distances from the origin sites of the STA to the level of carotid bifurcation (CB).A total of 220 carotids were retrospectively investigated. The 110 carotid arteries and branches were examined in 55 embalmed cadavers. The 110 carotid angiographs based on 2D digital subtraction and 3D rotational angiography examinations from 55 patients were analyzed. The data from both investigations showed the origin of the STA from the external carotid artery (ECA) in 26.8%, including branches of the thyrolingual trunks in 1.4%, whereas its origin at the CB level and the common carotid artery (CCA) was found as high as 73.2% of the samples. Regarding the sides, the origin from the ECA was dominant on the right while that from the CCA predominated on the left. The average vertical distance from external carotid origin site of the STA to the CB level was 4.6±2.9 millimeters.The average vertical distance from common carotid origin site of the STA to the CB level was 6.1±5.5 millimeters. It is noted that the origin sites of the STA arose within a range of 10 millimeters above the CB to 10 millimeters below the CB level in 95.5% of the carotids investigated. The present study revealed a relatively high incidence of the STA arising from the CCA and CB level in Thai. The surgical approaches of the neck at/below the CB level should be performed with great care of these STA origins in order to avoid accidental injuries.

Downloads

Download data is not yet available.

Article Details

Section
Research Articles

References

[1] Hayashi, N., Hori, E., Ohtani, Y., Ohtani, O., Kuwayama, N., Endo, S., 2005. Surgical anatomy of the cervical carotid artery for carotid endarterectomy. Neurologia Medico-Chirurgica 4, 25–29.

[2] Ozgur, Z., Govsa, F., Celik, S., Ozgur, T., 2009. Clinically relevant variations of the superior thyroid artery: an anatomic guide for surgical neck dissection. Surgical and Radiologic Anatomy 31, 151–159.

[3] Snell, R. S., 2012. Clinical anatomy by regions, 9th ed. Wolters Kluwer Health/Lippincott Williams& Wilkins, Baltimore.

[4] Moore, K. L., Dalley, A. F., Agur, A. M. R., 2014. Clinically oriented anatomy. 7th ed. Clinical Anatomy 27, 274. doi.org/10.1002/ca.22316

[5] Standring, S., 2016. Gray’s anatomy: the anatomical basis of clinical practice. 41st ed. Elsevier, Philadelphia.

[6] Klosek, S. K., Rungruang, T., 2008. Topography of carotid bifurcation: considerations for neck examination. Surgical and Radiologic Anatomy 30, 383–387.

[7] Natsis, K., Raikos, A., Foundos, I., Noussios, G., Lazaridis, N., Njau, S. N., 2011. Superior thyroid artery origin in Caucasian Greeks: A new classification proposal and review of the literature. Clinical Anatomy 24, 699–705.

[8] Ongeti, K. W., & Ogeng’o, J. A., 2012. Variant origin of the superior thyroid artery in a Kenyan population. Clinical Anatomy 25, 198–202.

[9] Won, S.-Y., 2016. Anatomical considerations of the superior thyroid artery: its origins, variations, and position relative to the hyoid bone and thyroid cartilage. Anatomy & Cell Biology 49, 138–142.

[10] Esen, K., Ozgur, A., Balci, Y., Tok, S., Kara, E., 2018. Variations in the origins of the thyroid arteries on CT angiography. Japanese Journal of Radiology 36, 96–102.

[11] Toni, R., Della Casa, C., Castorina, S., Malaguti, A., Mosca, S., Roti, E., Valenti, G., 2004. A meta-analysis of superior thyroid artery variations in different human groups and their clinical implications. Annals of Anatomy 186, 255–262.

[12] Michalinos, A., Chatzimarkos, M., Arkadopoulos, N., Safioleas, M., Troupis, T., 2016. Anatomical considerations on surgical anatomy of the carotid bifurcation. Anatomy Research 2016, Article ID 6907472.

[13] Espalieu, P., Cottier, M., Relave, M., Youvarlakis, P., Cuilleret, J., 1986. Radio-anatomic study of the carotid axis with regard to the implantation of microsurgical vascular anastomoses. Surgical and Radiologic Anatomy 8, 257–263.

[14] Remmert, S., Majocco, A., Gehrking, E., 1995. Neurovascular infrahyoid myofascial flap. Anatomic-topographic study of innervation and vascular supply. HNO 43, 182–187.

[15] Lucev, N., Bobinac, D., Maric, I., Drescik, I., 2000. Variations of the great arteries in the carotid triangle. Otolaryngology--Head and Neck Surgery 122, 590–591.

[16] Terayama, N., Sanada, J., Matsui, O., Kobayashi, S., Kawashima, H., Yamashiro, M., Takanaka, T., Kumano, T., Yoshizaki, T., Furukawa, M., 2006. Feeding artery of laryngeal and hypopharyngeal cancers: role of the superior thyroid artery in superselective intraarterial chemotherapy. Cardiovascular and Interventional Radiology 29, 536–543.

[17] Lo, A., Oehley, M., Bartlett, A., Adams, D., Blyth, P., Al-Ali, S., 2006. Anatomical variations of the common carotid artery bifurcation. ANZ Journal of Surgery 76, 970–972.

[18] Vázquez, T., Cobiella, R., Maranillo, E., Valderrama, F. J., McHanwell, S., Parkin, I., Sañudo, J. R., 2009. Anatomical variations of the superior thyroid and superior laryngeal arteries. Head & Neck 31, 1078–1085.

[19] Poisel, S., Golth, D., 1974. Variability of large arteries in the carotid trigone. Wiener medizinische Wochenschrift 124, 229–232.

[20] Joshi, A., Gupta, S., Vaniya, V. H., 2014. Anatomical variation in the origin of superior thyroid artery and it’s relation with external laryngeal nerve. National Journal of Medical Research 4, 138–41.

[21] Rajapriya, V., Ramya, T. P., Anjana, T. S. R., 2017. An anatomical study on the origin and length of the superior thyroid artery in adult human cadavers with its clinical significance. International Journal of Anatomy and Research 5, 3421–3425.

[22] Budhiraja, V., Rastogi, R., 2010. Variant origin of thyrolingual trunk from left common carotid arterythe. International Journal of Anatomical Variations 3, 44–45.

[23] Kapre, M., Mangalgiri, A. S., Mahore, D., 2013. Study of thyro-lingual trunk and its clinical relevance. Indian Journal of Otolaryngology and Head and Neck Surgery 65, 102–104.

[24] Shintani, S., Terakado, N., Alcalde, R. E., 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. International Journal of Clinical Oncology 4, 327–330.

[25] Moore, K. L., Persaud, T. V. N., Torchia, M. G., 2016. The developing human: clinically oriented embryology, 10th ed. Elsevier, Philadelphia.