口咽部颈内动脉异位误诊为咽侧壁肿物临床诊疗分析
Clinical Analysis of the Misdiagnosis of Oropharyngeal Internal Carotid Artery Ectopy as Lateral Pharyngeal Wall Tumor

正常的颈内动脉由颈总动脉发出后，在咽的外侧垂直上行至颅底，再经颈动脉管入颅。颈内动脉位于颈动脉三角内平甲状软骨上缘，起自颈总动脉，与颈外动脉伴行，开始在颈外动脉的后外侧上行，继而转向其后内侧，沿咽侧壁和椎前筋膜前侧上到颅底，再经颈动脉管进入颅中窝。颈内动脉走行位置及走行路线偏离正常路径者被视为颈内动脉异位。口咽部颈内动脉异位较少见，常无明显临床症状，临床诊断较为困难，临床上如果误诊为囊肿，血管瘤等而采取外科手术，危及患者生命，所以准确诊断口咽部颈内动脉异位非常重要，口咽部颈内动脉异位依靠影像学检查确诊。颈段的颈内动脉异位与耳鼻咽喉头颈外科息息相关，因此，该科室的临床医生在诊治过程中需要排除颈内动脉异位，避免造成不可逆转的后果。现回顾性分析误诊为咽侧壁肿物的口咽部颈内动脉异位1例，使得临床医师对于口咽部颈内动脉血管的变异有更深刻的了解，避免发生危险的并发症。
The normal internal carotid artery, after emanating from the common carotid artery, travels vertically up the lateral part of the pharynx to the skull base, and then enters the skull through the carotid canal. The internal carotid artery is located at the upper margin of the plain thyroid cartilage in the carotid triangle, starting from the common carotid artery and accompanying the external carotid artery, ascending posterolateral to the external carotid artery, then turning posterolateral to the skull base along the parietal pharynx and anterior to the prevertebral fascia, and then entering the middle cranial fossa through the carotid canal. The position and route of the internal carotid artery deviated from the normal path was considered as ectopic internal carotid artery. Oropharyngeal internal carotid artery ectopia often has no obvious clinical symptoms, clinical diagnosis is difficult, clinical misdiagnosis is often based on imaging diagnosis. Ectopia of internal carotid artery in the neck is closely related to otorhinolaryngology and head and neck surgery. Therefore, clinicians in this department need to exclude ectopia of internal carotid artery during diagnosis and treatment to avoid irreversible consequences. We retrospectively analyzed 1 case of oropharyngeal internal carotid artery ectopic misdiagnosed as lateral pharyngeal wall mass, which enabled clinicians to have a deeper understanding of the variation of oropharyngeal internal carotid artery vessels and avoid dangerous complications.