Anatomical classification of the ascending pharyngeal artery branches and its clinical implications
Zuo Fuxing1, Wan Jinghai1, Li Mingchu2
1Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; 2Department of Neurosurgery, Capital Medical University Xuanwu Hospital/China International Neuroscience Institute (China-INI), Beijing 100053, China
Abstract：Objective To explore the anatomical characteristics of the ascending pharyngeal artery (APA) and the major trunks in the skull base and evaluate the implications. Methods The origin, course, and branching patterns of APA were observed in eight human cadaveric specimens (16 sides), which were fixed in a 10% formalin solution and then injected with colored latex. The relationship between the APA and its surrounding structures were observed. Data were measured and analyzed, focusing on the relationship between the APA and the carotid sheath. Results In 13 sides of the specimens, the APA originated from the external carotid artery, lying inferior to the origin of the facial artery. The APA could originate directly from the occipital artery (two sides) or share a common trunk with the occipital artery in one side. Before the bifurcation into the pharyngeal and meningeal trunks, the mean length of the common trunk of the APA was (15.39 ± 3.20) mm (14 sides). The bifurcation of the APA varied in two sides of the specimens. The meningeal trunk entered the carotid sheath (CS) and extended toward intracranial regions through the hypoglossal canal, jugular foramen, inferior tympanic foramen, and foramen magnum. The mean distance from the origin of the meningeal trunk to the CS was (9.32 ± 3.20) mm. The pharyngeal trunk did not enter the CS but gave rise to arterial arcade surrounding the parapharyngeal and paravertebral spaces. The major branches of the APA were classified into two groups. Intra-CS group included the meningeal trunk and inferior tympanic artery, which coursed into the CS medially to the internal carotid artery (ICA). Extra-CS group was composed of the pharyngeal trunk and muscular branches, which did not enter the CS. Conclusions The APA and its branches have significant variation and complicated course. They could be divided into groups according to the positional relationship between the main branches of the APA and the CS. The clinical application value of using CS as an anatomic marker to make individualized intravascular and extravascular treatment plan for patients with head and neck lesions remains to be proved.
左赋兴, 万经海, 李茗初. 咽升动脉分支的解剖分组及其临床意义[J]. 中华解剖与临床杂志, 2022, 27(5): 297-301.
Zuo Fuxing, Wan Jinghai, Li Mingchu. Anatomical classification of the ascending pharyngeal artery branches and its clinical implications. Chinese Journal of Anatomy and Clinics, 2022, 27(5): 297-301.
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