%0 Journal Article
%T Bilateral Lower Cervical Bifurcation of the Common Carotid Artery
%A Lokman Uzun
%A Numan Kokten
%A Adem Kilicaslan
%A Bulent Tasel
%A M. Tayyar Kalcioglu
%A Muhammet Tekin
%J Case Reports in Otolaryngology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/894804
%X Lower cervical bifurcation of cervical common carotid artery (CCA) is a very rarely encountered anatomic variation. Knowing the normal vascular anatomy and also its anomalies is important in preventing the vascular complications. Ill-defined vascular anomalies may lead to massive hemorrhage and eventually death during head and neck surgery. Imaging of the neck by magnetic resonance Imaging (MRI), CT, or angiography is helpful for diagnosis. We present a 62-year-old male patient diagnosed with laryngeal carcinoma who had been treated. His MRI revealed bilateral low-level bifurcation of the cervical common carotid arteries as well as tumor localization and its boundaries. Total laryngectomy and right selective neck dissection was performed to the patient with the diagnosis of squamous cell carcinoma of the larynx. During the neck dissection, carotid bifurcation was detected in common border of Level 3 and Level 4 of the neck. 1. Introduction The neck harbours many vital anatomic structures such as vagus nerve and its branches, carotid arteries, esophagus, and so forth. During the neck surgery, inadvertent injury to these vital structures may cause serious, life-threatening complications. Knowing the normal anatomy and also its anomalies is important in preventing these complications. A wide variety of carotid artery anomalies or anatomic variations which include aplasia, agenesis, tortuosity, hypoplasia, trifurcation, kinked, curved, anomalous origin, independent origins, nonbifurcation cervical carotid artery, and aberrant artery were reported [1¨C8]. In some rare cases, thoracic bifurcation of the common carotid artery (CCA) may be seen. Newly, Gomez and Arnuk reported the seventh case of the thoracic bifurcation of the common carotid artery [9]. Lower cervical bifurcation of the carotid arteries is a rarely seen anomaly of the carotid artery. Orr first reported the case of the lower cervical carotid artery bifurcation in 1906 [10]. In this paper, we report the case of a 62-year-old man with bilateral low-lying bifurcation of the CCA, and we emphasize the importance of anatomic variations of the carotid artery during the neck surgery. 2. Case Report We present a 62-year-old male patient who was admitted to our hospital with dysphonia and dyspnea for three months. Laryngeal endoscopy revealed ulcerovegetans tumor on right true and false vocal cord. MRI revealed bilateral low-level bifurcation of the cervical common carotid arteries as well as tumor localization and its boundaries. Three-dimensions time-of-flight (3D ToF) images of MR-angiography showed
%U http://www.hindawi.com/journals/criot/2013/894804/