International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 4(22), November, 2012

Pages: 63-65

Date of Publication: 24-Nov-2012


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FACIO-LINGUAL TRUNK - A CASE REPORT

Author: Pushpalatha M., Sujana M., Sharmada K.L.

Category: Healthcare

Abstract:The external carotid arterial system is a complex vascular system. It supplies the head, face and neck tissues. Variations in its course, branching and distribution are commonly encountered. Study of these variations are important as the anatomy of the external carotid artery and its surrounding nerves are studied for safe and accurate administration of super selective intra arterial chemotherapy via superficial temporal artery [1] as it is extremely important avoiding complications. As the branching variations are observed in individuals and sides. Preoperative angiography is a must [1].

Keywords: External carotid artery, superficial temporal artery, Angiography, Intra arterial chemotherapy.

Full Text:

INTRODUCTION
External carotid artery is one of the terminal branches of common carotid artery at the level of superior border of thyroid cartilage in carotid triangle [2]. The facial artery normally arises from the external carotid artery, just above the lingual artery, at the level of greater cornu of hyoid bone in the carotid triangle. It then passes upwards and forwards medial to the ramus of the mandible [3]. The lingual artery is typically the second branch taking origin anteriorly from the external carotid artery and may arise either below or under cover of posterior belly of digastric [4]. It is important for surgeons and radiologists to be aware of the normal anatomy of branches of common carotid artery since variations among these arteries are quite common; surgeons should be able to differentiate between the facial and the lingual artery to ensure accurate arterial ligation during Oral and Maxillo-Facial surgery and Radical Neck dissection. This knowledge can also help radiologists to understand and interpret Carotid system Imagings [5].

CASE REPORT
During routine dissection for 1st year medical undergraduate students in Anatomy Department in BMCRI, variation in the origin of facial and lingual artery from external carotid on left side was observed in a male cadaver. The lingual artery and facial artery were originating on left side as the common facio-lingual trunk from the anterior side of external carotid artery, 12mm from carotid bifurcation 10mm above the origin of superior thyroid artery. The facio-lingual arterial trunk was running medially and upwards which was crossed by hypoglossal nerve. The facial and lingual arteries were separated from the common trunk at a distance of 6mm from the origin of the common trunk. The facial and lingual artery was normal on right side. The venous drainage system of the neck was normal on both sides.

DISCUSSION
Variations in branching pattern of carotid system are well known; common variations being lingual and facial arteries arising from the common carotid artery and posterior auricular, maxillary and superficial temporal arteries originating from the common carotid artery by a common trunk. In some cases no specific external carotid artery was observed [6]. The bifurcation level of the common carotid artery and origin variations of the branches of the external carotid artery was studied in 20 human fetuses. Results showed linguofacial trunk present in 20% of cases and a thyrolinguofacial trunk in 2.5% [7]

Vascular tortuosity in the preauricular region of the catheter insertion site was observed in 42.9% of the sides; the main trunk of the external carotid artery was excessively tortuous in 25% of the sides, primarily in the preparotid region. Faciolingual and superior thyrolingual trunks were observed in 28.6% and 1.8% of the sides respectively [1]. A common trunk from external carotid artery giving rise to lingual and facial arteries has been reported [8]. A study to improve the treatment for locally advanced tongue cancer needed a combination of radiotherapy with continuous intra arterial therapy CBDCA. For this procedure a catheter was inserted through lingual artery in 26 patients out of 40 and in 2 through facio-lingual trunk and in 12 through external carotid artery [9].

CONCLUSION
Thus the variations in the branching pattern of external carotid artery are rare findings providing knowledge useful for surgeons operating on face and neck regions, for radiologists in the interpretation of imaging. The present case thus would provide useful information for clinical applications since most of the cosmetic surgeries take place in head and neck regions.

References:

1. Yonenaga K, Tohnai I, Mitsudo K, Mori Y, Saijo H, Jwai T, Yonehara Y, Ota Y, Torigoe K, Takato T. Department of Oral and Maxillofacial surgery, Tokyo university Graduate school of Medicine, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan. Yonenaga-_tky@umin.ac.jp

2. Standring S.ed Gray’s Anatomy, 40th edition, New York, Churchill Livingstone. 2008;444- 45.

3. Nayak S. Abnormal intraparotid origin of the facial artery, Saudi Med J, 2006; 27(10):1602

4. Hollinshed WH Anatomy for surgeons vol.1. 3 rd ed., Phelidelphia, Harper and Row. 1982; 374-375 

5. Thwin S S, Soe MM, Myint M, Than M, Lwin S. Variations of the origin and branches of the external carotid artery in a human cadaver. Singapore Med Case Report J 2010; 51(2) : e40.

6. Kaneko K, Akita M, Murata E, Imai M, Sowa K, Unilateral anomalous left common carotid artery; a case report. Ann Anat. 1996;178:477-480.

7. Zumre O, Saiback A, Cicekcibasi AE, Tuncer I, Seker M. Investigation of the bifurcation level of the common carotid artery and variations of the branches of the external carotid artery in human fetuses. Ann Anat. 2005 sep;187(4):361-9

8. Troupis TG, Dimitroulis D, Paraschos A, Michalinos A, Protogerou V, Valsis K, Troupis G, Skandalakis P. Department of Anatomy, Medical school, National and Kapodistrian University of Athens, Athens, Greece. ttroupis@med.uoa.gr

9. Department of Radiation Oncology, Aichi cancer center Hospital, Nagoya, Japan. nfuwa@aichi-cc.jp

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One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

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This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

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‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


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List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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