Ramazan ÖÇALAN, Fatma Ceyda Akın ÖÇALAN, Zeliha Korkmaz DİŞLİ, Samet ÖZLÜGEDİK, Adnan ÜNAL

Boyunda Anormal Seyir İzleyen Arteria Carotis Interna

Arteria carotis interna anomalileri son derece nadir olup cerrahi sırasında beklenmedik komplikasyonlara neden olabilir Boyunda kitle şikayeti ile kulak burun boğaz kliniğine kabul edilen 83 yaşındaki hastanın boyun magnetik rezonans incelemesinde boyun sağ tarafında angulus mandibula'nın inferiorunda, sternokleidomastoid kası anterolateralinde dev kitle lezyonu saptandı. Yapılan ince iğne aspirasyon biyopsisinde malign melanoma tespit edildi. Yapılan ileri tetkikler sonucu hastanın tanısı primeri bilinmeyen boyun metastazı olarak kabul edildi ve hastaya cerrahi sonrası kemoradyoterapi planlandı. Radikal boyun diseksiyonu sırasında arteria carotis interna'nın üzeri superiora doğru diseke edilirken arterin posteriora doğru sifon şeklinde anormal bir yaylanma yaptığı görüldü. Bu tür anomaliler nadir görülen varyasyonlar olmasına rağmen boyun cerrahisi sırasında hastanın yaşamını tehdit eden ciddi komplikasyonlara neden olabilir. Anahtar kelimeler: Arteria Karotis Interna; Boyun; Komplikasyonlar.

Anahtar Kelimeler:

Arteria Karotis Interna; Boyun; Komplikasyonlar

An Abnormal Course of the Internal Carotid Artery in the Neck

Internal carotid artery anomalies are extremely rare and may cause unexpected complications during surgery. The magnetic resonance imaging of the neck of a 83-year old patient was admitted to the ear,nose, and throat clinic with a mass in the neck, which was reported to be a giant mass lesion in the right side of the neck, inferior of the angle of mandible, to the anterolateral of the sternocleidomastoid muscle. After the fine needle aspiration biopsy the patient was thought to be a malignant melanoma case, making us plan chemoradiotherapy after the surgery. During the radical neck dissection, while the surface of the internal carotid artery was being dissected superiorly, it was noticed that the artery was springing abnormally in the form of the siphon posteriorly. Although these types of anamolies are rare variations, they can cause serious life-threatening complications during neck surgery. Key Word: Internal Carotid Artery, Neck; Complications.

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Arıncı K, Elhan A. Anatomi 2.cilt. 4. Baskı. Ankara: Güneş Tıp Kitapevleri; 2006.p. 33-8.
Aygenç E, Gür E, Öksüzler Ö, Özdem C. İnternal Karotid Arter Anomalisi: Olgu Sunumu. KBB ve BBC Dergisi, 2006;14:72–4.
Bussuttil R, Memsic L, Thomas D. Coiling and kinking of the carotid artery. Vascular Surgery 1989;2:1406-11.
Barbour PJ, Castaldo JE, Rae-Grant AD, Gee W, Reed JF 3rd, Jenny D, et al. Internal carotid artery redundancy is significantly associated with dissection. Stroke 1994;25:1201-06.
Weibel J, Fields WS. Tortuosity, Coiling, and kinking of the internal karotid artery. Etiology and radiographic anatomy. Neurology 1965;15:7-18.
Weibel J, Fields WS. Tortuosity, Coiling, and kinking of the internal karotid artery. Etiology and radiographic anatomy. Neurology 1965;15:462-8.
Leipzig TJ, Dohrmann GJ. The tortuous or kinked carotid artery: pathogenesis and clinical considerations. A historical review. Surg Neurol 1986;25:478-86.
Ozgur Z, Celik S, Govsa F, Aktug H, Ozgur T. A study of the course of the internal carotid artery in the parapharyngeal space and its clinical importance. Eur Arch Otorhinolaryngol 2007;264:1483-89.
Claros P, Bandos R, Gilea I, Claros A Jr, Capdevila A, Garcia Rodriguez J, et al. Major congenital anomalies of the internal carotid artery: agenesis, aplasia and hypoplasia. Int J Pediatr Otorhinolaryngol 1999;49:69-76.
Oğretmenoğlu O. Asymptomatic looping of the internal carotid artery: a case report. Kulak Burun Bogaz Ihtis Derg 2004;12:144-46. www.jtomc.org
Sichel JY, Chisin R. Tortuous internal carotid artery: a rare cause of oropharyngeal bulging diagnosed by magnetic resonance angiography. Ann Otol Rhinol Laryngol 1993;102:964-66.
Bektaş D, Caylan R, Korkmaz O, Savaş FS. Acquired and congenital internal carotid artery anomalies in two cases: an important threat for the otolaryngologist. Kulak Burun Bogaz Ihtis Derg 2004;13:35-37.