Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2025, Vol. 39 ›› Issue (4): 69-76.doi: 10.6040/j.issn.1673-3770.0.2024.376

• Clinical Research • Previous Articles     Next Articles

Imaging-based observation and analysis of the pharyngeal internal carotid artery trajectory

JIANG Zhilin1, ZHU Ruikai1,2, QIU Qianhui1   

  1. 1. Department of Otorhinolaryngology & Head and Neck Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, Guangdong, China2. Department of Otorhinolaryngology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai 519000, Guangdong, China
  • Online:2025-07-20 Published:2025-08-11

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Abstract: Objective The objective of this study was to delineate the course of the pharyngeal segment of the internal carotid artery(ICA)through imaging analysis, with the aim of providing guidance to prevent ICA injury during endonasal endoscopic surgeries. Methods A retrospective analysis of MRI and CTA imaging data from patients' ICAs was conducted, with arterial morphologies being classified based on inflection points. The distances and angles between the ICA and key anatomical landmarks(midline, intracranial entry plane, pharyngeal wall)were measured in multiple dimensions to identify any patterns that could inform surgical approaches. Results In the course of the evaluation of 124 ICA sides, it was found that nine of these exhibited complex trajectories with multiple inflection points. The conventional ICA course exhibited a medial trend, with a mean coronal distance from the midline of(21.85±3.26)mm, an intracranial entry angle of(76.32±15.53)°, and a mean sagittal entry angle of(71.84±11.55)°. It is noteworthy that a critical intracranial entry angle of 60° was identified in the coronal view of CTA scans, suggesting a threshold for surgical risk. Conclusion Variations in the ICA have the potential to result in surgical channel stenosis and alterations in anatomical landmark relationships, which are of critical importance for the purpose of planning. Comprehensive imaging assessments are essential for identifying pharyngeal ICA anomalies, and preoperative interventions should be considered when indicated to mitigate surgical risks.

Key words: Endoscopic endonasal skull base surgery, Internal carotid artery injury, Course of internal carotid artery, Anatomy, Imaging, Preoperative assessment

CLC Number: 

  • R574
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