ABSTRACT
La hemorragia producida por lesión de la arteria lingual en la base de la lengua por cirugías o por tumores es infrecuente. La mayor frecuencia en la indicación de abordajes transorales para tratar diferentes patologías que afectan la orofaringe requiere que el equipo quirúrgico tenga experiencia en el manejo de esta complicación. La ligadura de la arteria lingual en el cuello es una técnica quirúrgica muy eficaz para solucionar la hemorragia, pero es importante conocer las posibles variantes anatómicas que puede tener la arteria en su trayecto cervical. Debido a su baja incidencia se propone como objetivo describir dos casos clínicos de pacientes que tuvieron hemorragias graves por lesión de la arteria lingual en la base de la lengua, producidas por daño quirúrgico y por erosión por tumor. [AU]
The bleeding caused by injury to the lingual artery at the base of the tongue due to surgery or tumors is infrequent. The increased frequency in the indication of transoral approaches to treat different pathologies affecting the oropharynx requires the surgical team to have experience in managing this complication. Ligation of the lingual artery in the neck is a very effective surgical technique to solve the bleeding; however, it is essential to be aware of the possible anatomical variants the artery may have in its cervical trajectory. Due to its low incidence, we propose to describe two clinical cases of patients who had severe bleeding due to a lesion of the lingual artery at the base of the tongue, produced by surgical damage and erosion due to a tumor. [AU]
Subject(s)
Humans , Male , Middle Aged , Aged , Tongue/surgery , Tongue/blood supply , Oral Hemorrhage/therapy , Tongue/anatomy & histology , Ligation/methodsABSTRACT
Background: The common carotid artery (CCA) divides at the level of superior border of thyroid cartilage. Theexternal carotid artery (ECA) is one of the terminal branches of CCA. ECA gives three anterior branches, Superiorthyroid (STA), Lingual (LA) and Facial arteries (FA). Therefore the present study was carried out to describe thelevel of bifurcation of CCA, its relations with anatomical landmarks and the morphometry of anterior branchesof ECA in relation to bifurcation of CCA.Methods: The present study was carried on 30 sagittal head and neck sections. The level of bifurcation of CCAwas noted. The distances from CCA bifurcation to the superior border of thyroid cartilage (SBTC), angle ofmandible, ear lobule were measured. The ddistances of STA, LA & FA from CCA bifurcation were also measured.Results: In 16 (53.33%) cases the bifurcation of CCA was observed at the level of SBTC, 2 (6.67%)It was between SBTC and hyoid bone, in 5 (16.67%) below SBTC and in 6 (20%) at the level of hyoid bone. The meandistances from the bifurcation of CCA to the SBTC was 24 ± 0.95mm, to the angle of the mandible was 31 ± 0.86mmand to the ear lobule was 54.8 ± 0.96mm. The mean distances of STA, LA and FA from CCA bifurcation were 7.2 ± 0.2,12 ± 0.45 and 17.6 ± 0.48 cm respectively.Conclusion: The anatomical study of CCA is useful for angiographies, thyroid and head and neck surgeries. Incase of common trunks, stenosis or occlusion may cause severe ischemic consequences and prone toatherosclerosis.
ABSTRACT
Prior knowledge of arterial supply to the head and neck is of substantial importance for well-planned surgeries involving the concerned region. We are reporting an unusual and rare variation in the branching pattern of external carotid artery in a 60-year-old female cadaver. A common trunk known as thyrolinguofacial trunk, originating from the anterior surface of the external carotid artery (right and left) giving of superior thyroid artery and a linguofacial trunk during a routine neck dissection. The linguofacial trunk then divided into a lingual and a facial artery. Vascular abnormalities are usually detected either on the dissection table or by the radiologists during imaging or accidently during surgeries leading to serious consequences.
Subject(s)
Female , Humans , Middle Aged , Arteries , Cadaver , Carotid Artery, External , Head , Neck , Neck Dissection , Thyroid GlandABSTRACT
To explore the clinical value of superselective lingual artery embolization in treating the severe hemorrhage in patients with advanced carcinoma of tongue. Four patients with advanced tongue cancer hemorrhage from March 2014 to February 2016 were enrolled in this study. T3N2M0 (2 cases) and T4N1M0 (2 cases) were diagnosed preoperatively. Two cases of advanced tongue carcinoma tumors had severe bleeding and the other 2 cases of hemorrhage were after radiotherapy. All cases including 3 squamous cell carcinoma and 1 adenocarcinoma were firstly demonstrated by arterigraphy under seldinger technique with digtial subtraction angiogarphy to ensure the rupture site and then all cases were followed by superselective artery embolization. The efficacy and complications of interventional embolizationg were observed. There was no serious complication of central nervous system injury such as hemorrhage and hemiplegia during follow-up. Superselective lingual artery embolization can accurately locate the responsibility of blood vessels, and the injury is small, significant effect, fewer complications.
ABSTRACT
The sternocleidomastoid (SCM) artery supplying blood to the SCM muscle has different origins according to its anatomical segment. The authors performed cadaveric neck dissection to review the surgical anatomy of neurovascular structures surrounding the carotid artery in the neck. During the dissection, an unusual finding was cited in which the SCM artery supplying the middle part of the SCM muscle originated from the lingual artery (LA); it was also noted that it crossed over the hypoglossal nerve (HN). There have been extremely rare reports citing the SCM artery originated from the LA. Though the elevation of the HN over the internal carotid artery was relatively high, the vascular loop crossing over the HN was very close to the carotid bifurcation. Special anatomical consideration is required to avoid the injury of the HN during carotid artery surgery.
Subject(s)
Arteries , Cadaver , Carotid Arteries , Carotid Artery, Internal , Crossing Over, Genetic , Hypoglossal Nerve , Muscles , Neck , Neck DissectionABSTRACT
The lingual artery constitutes one of the branches of the external carotid artery, which is responsible for the vascularization of the tongue and neighbour regions. The hemorrhage caused by a lesion of the lingual artery can occur during a dental procedure (surgical accidents by the use of an instrument or rotating disc), by trauma, biopsy and dental implant. In some cases is difficult to stop the hemorrhage of injured vase, so is necessary to realize the extraoral ligature of this artery. Hence, this work studied the anatomic aspects of the lingual artery, by forty-eight dissections of twenty-four corpses settled in formol 10%, aiming to detail the origin, pathway and anatomic relations of the lingual artery in the region of anterior trigone of the neck, and also to measure the distances among the lingual artery and the arteries: facial, superior thyroid and with the bifurcation of the common carotid. The results concluded that the lingual artery is found in a position more inferior than classicaly described, based on the digastric muscle and the hypoglossal nerve; and that the hyoid bone can be used as a point of reference for the surgical access to the lingual artery in the region of the anterior trigone of the neck.
La arteria lingual es un ramo de la arteria carótida externa, responsable de la vascularización de la lengua y regiones vecinas. La hemorragia proveniente de una lesión de la arteria lingual puede ocurrir durante el procedimento dental (accidentes operatorios por un instrumento quirúrgico o disco rotatorio), por trauma, biopsia y por colocación de implante dentario. Como en algunos casos, se vuelve difícil contener la hemorragia donde el vaso fue lesionado, se hace necesario realizar la ligadura extra-oral de esta arteria. Por lo anterior, en este trabajo fueron estudiados los aspectos anatómicos de la arteria lingual, en 48 disecciones de cadáveres humanos fijados en formol 10%, con el objetivo de detallar el origen, trayecto y relaciones anatómicas de esta arteria en la región del trígono anterior del cuello, como también medir las distancias entre la arteria lingual y las arterias: facial, tireoidea superior y con la bifurcación de la arteria carótida común. Los resultados permitieron concluir que la arteria lingual se encuentra, generalmente, más inferior de lo clásicamente descrito, tomándose como base el músculo digástrico y el nervio hipogloso; y que el hueso hioide puede ser usado como punto de referencia para el acceso quirúrgico a la arteria lingual, en la región del trígono anterior del cuello.
Subject(s)
Humans , Male , Adult , Arteries/anatomy & histology , Tongue/blood supply , CadaverABSTRACT
False aneurysms (Pseudoaneurysms) and arteriovenous fistulas have only rarely been reported in the facial region. In this region the false aneurysm arises most frequently in the superficial temporal and facial artery, but other branches of the external carotid are sometimes involved, including the maxillary and lingual artery. False aneurysms can be occurred by blunt trauma that either laceration or rupture the full thickness of the arterial wall. The diagnosis of a false arterial aneurysm can be often made solely on the basis of physical examination. Angiography is helpful for conformation, for delineating the lesion and its vascular supply, and for ruling out the presence of associated vascular lesions such as arteriovenous fistulas. Ultrasonography may also be useful in delineating lesions that are not easily accessible for physical examination. Treatment of false aneurysms is excision, ligation, and arterial embolization. This is a case of false aneurysm of the lingual artery after facial trauma caused by traffic accident. The lesion was successfully treated by embolization and ligation of the lingual and facial branches of the external carotid artery.
Subject(s)
Accidents, Traffic , Aneurysm , Aneurysm, False , Angiography , Arteries , Arteriovenous Fistula , Carotid Artery, External , Diagnosis , Lacerations , Ligation , Physical Examination , Rupture , UltrasonographyABSTRACT
Objective: To provide anatomical basis for the chemotherapy of lingual arterial embolization in clinic. Methods: The origin, course, branch distribution and anastomosis of the lingual artery were observed in 15 cases of adult head specimens. Results: As one of principal branches, the lingual artery arises from the external carotid artery at the level of the major cornu of hyoeides, approaches to the carotid bifurcation. With original diameter of (2.4?0.3) mm, it runs upward and passes deepwards to the hyoglossus muscle, gives off the dorsal lingual artery and the terminal branch -profunda lingual artery. Limited in each side of intrinsic muscles, two profunda lingual arteries creep tortuously along the muscular fibers and anastomose freely to structure submucous arterial rete. Conclusion: With concentrated origins, wide vascular diameter, constant course and enrichment of submucous arterial rete, the lingual artery is an ideal blood vessel for arterial chemoembolization.
ABSTRACT
In order to clarify the topographical morphology of the Korean lingual artery related to clinical problems, authors investigated the morphological variations of the lingual artery through the dissection of the deep layer of head and neck. 61 -sides of Korean adult cadavers (mean age 57.8) were used for this study. The morphlogy of the origin sites of the lingual artery were classified into three types. The cases that the superior thyroid, lingual, and facial artery were originated independently from the external carotid artery were most common (56.3%). Others were the cases that the lingual artery and the facial artery were divided from the linguofacial trunk (31.2%), and the cases that the superior thyroid artery and the lingual artery were divided from the thyreolingual trunk (12.5%) from the external carotid artery, respectively. In the topographical relationships between the first part of the lingual artery and the hyoglossus muscle, the cases that the first part of the lingual artery formed loop posterior to the hyoglossus muscle (41.2%) and the cases that the lingual artery penetrated into the medial aspect of the hyoglossus muscle passing the posterior border of this muscle (66.1%) were observed most frequently. Others were the cases that the lingual artery penetrated into the posterior muscle fiber (18.6%) and the middle muscle fiber (15.3%) of the hyoglossus muscle. The courses of the second part of the lingual artery deep to the hyoglossus muscle could be classified into two morphlogical types. One was that the second part of the lingual artery ran superiorly from the origin site and then turned abruptly towards deep portion of hyoglossus muscle. In these cases, the artery turned upward again at the inside of the muscle, and then reached to the sublingual region (42.6%). The other cases were that the lingual artery ran gradually to the medial and superior aspect of the sublingual region (57.4%). The prevalency of the sublingual arteries originating from the lingual arteries was 59%. Taken all together, authors concluded that the mouth floors of Korean are supplied by both the lingual and facial artery. So, performing the hemostatic procedures in the mouth floor region, the surgeon must take a topographical anatomy of this region related the arterial supply into account.