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A Description of Arterial Variants in the Transoral Approach to the Parapharyngeal Space

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单位: [1]China Japan Friendship Hosp, Dept Otolaryngol Head & Neck Surg, Beijing, Peoples R China [2]Univ Pittsburgh, Med Ctr, Dept Neurosurg, Pittsburgh, PA 15213 USA [3]Univ Pittsburgh, Med Ctr, UPMC Dept Otolaryngol Head & Neck Surg, Vet Affairs Pittsburgh Hlth Syst,Eye & Ear Inst, Pittsburgh, PA 15213 USA
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关键词: robotic surgery TORS parapharyngeal space arterial variants

摘要:
This study demonstrates variations in the vascular anatomy of the parapharyngeal space (PPS) as seen from the transoral approach compared with the transcervical approach. The PPS was dissected in injected cadaveric specimens. Anatomical measurements, including those of branches of the external and internal carotid arteries (ECA and ICA) and the styloglossus and stylopharyngeus muscles, were recorded and analyzed. In 67% (8/12) of cases, the ascending palatine artery (APA) originated from the facial artery and crossed the styloglossus muscle. The diameter of the APA at its origin was 1.4 +/- 0.3mm. In 75% (9/12) of cases, the ascending pharyngeal artery (aPA) arose from the medial surface of the ECA near its origin. In 58% (7/12) of cases, the aPA ascended vertically between the ICA and the lateral pharynx to the skull base, along the longus capitus muscle. The aPA crossed the styloglossus muscle 12.6 +/- 3.9mm from the insertion into the tongue. In 92% (11/12) of cases, the ECA and ICA were separated by the styloid diaphragm and pharyngeal venous plexus. In 8% (1/12), the ECA bulged into the parapharyngeal fat between the styloglossus and stylopharyngeus muscles adjacent to the pharyngeal constrictors. Knowledge of the precise anatomy of the PPS is important for transoral robotic surgery (TORS). Control of the vessels that supply and traverse the PPS can help the TORS surgeon avoid those critical structures and reduce surgical morbidity and potential hemorrhage. (C) 2014 Wiley Periodicals, Inc.

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出版当年[2013]版:
大类 | 4 区 医学
小类 | 4 区 解剖学与形态学
最新[2025]版:
大类 | 4 区 医学
小类 | 2 区 解剖学与形态学
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出版当年[2012]版:
Q3 ANATOMY & MORPHOLOGY
最新[2023]版:
Q1 ANATOMY & MORPHOLOGY

影响因子: 最新[2023版] 最新五年平均[2021-2025] 出版当年[2012版] 出版当年五年平均[2008-2012] 出版前一年[2011版] 出版后一年[2013版]

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第一作者单位: [1]China Japan Friendship Hosp, Dept Otolaryngol Head & Neck Surg, Beijing, Peoples R China [2]Univ Pittsburgh, Med Ctr, Dept Neurosurg, Pittsburgh, PA 15213 USA
通讯作者:
通讯机构: [3]Univ Pittsburgh, Med Ctr, UPMC Dept Otolaryngol Head & Neck Surg, Vet Affairs Pittsburgh Hlth Syst,Eye & Ear Inst, Pittsburgh, PA 15213 USA [*1]Univ Pittsburgh, Med Ctr, Dept Otolaryngol, Vet Affairs Pittsburgh Hlth Syst,Eye & Ear Inst, Suite 500,200 Lothrop St, Pittsburgh, PA 15213 USA
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