2 articles
The common carotid artery is the main source of blood supply to the head and neck regions. Its branching patterns are of great interest in terms of both anatomical and clinical significance. Variability of the common carotid artery can influence the planning of vascular, endovascular and oncological interventions in the head and neck regions, to avoid vessel injuries as well as intra-operative and postoperative complications.
Variants of branching patterns of the common carotid artery were studied retrospectively on a sample size of 210 patients (118 males and 92 females). The mean age of patients was 63.6±13.44 years for males and 65.1±14.32 years for females (p = 0.444). Patients were examined by CT angiography, during the period 2020-2024, within the Institute of Emergency Medicine and Republican Center for Medical Diagnostics. The purpose of this article was to identify anatomical variations in the branching pattern of the CCA based on gender and laterality.
The most frequent variant of the CCA branching pattern, considered a normal variant, was its bifurcation, identified on the right side in 70% of cases (n = 147) and on the left side in 54% (n = 113). The trifurcation of the CCA was more common on the left side (33.3%), compared to the right side (25.7%). The origin of the superior thyroid artery from the CCA trunk was observed in 12.8% of cases on the right side and in 3.8% on the left one. A rare variant revealed in the current study was the origin of the lingual artery from the CCA trunk (0.4%).
The branching variants of the common carotid artery are of clinical significance, particularly in surgical interventions on the neck. Knowledge of the topographic relationships of the CCA with the neighboring anatomical landmarks is essential to prevent intra-operative complications and improve the quality of surgical management.
The data reported in the specialty literature on the embryogenesis of the facial nerve mainly refer to the initial stages of its development. Nevertheless, the intrauterine development of the facial nerve is a complex and insightful process, characterized by a range of peculiarities. The goal of our study was to highlight the specific developmental features of the facial nerve for a better understanding of its morphology in adults.
Fifty-two groups of serially sectioned human embryos and fetuses from the embryo-fetal collection of the Department of Normal Anatomy at the Belarusian State Medical University in Minsk were investigated. The embryonic samples were classified according to Carnegie stages (day of gestation and crown-rump length). For protocols description, an OLYMPUS CX31 binocular microscope (eyepiece 10x, objectives 4x; 10x; 40x; 100x) and a Nikon DS-Fi1 camera were used.
The primary and secondary divisions of the facial nerve trunk, the chorda tympani, the greater petrosal nerve, and the intracerebral and peripheral connections of the facial nerve were distinguished at Carnegie stage 15. The first appearance of intraplexal connections within the parotid plexus was identified at Carnegie stage 16. At stage 20, thin connections between the geniculate ganglion and the vestibular ganglion were revealed. Macro- and microstructural changes in the geniculate ganglion were noted throughout its development. The plexiform nature of the peripheral divisions of the facial nerve and the formation of the pes anserinus minor were observed at stage 21. At Carnegie stage 23, the motor nucleus was well developed, and the internal knee of the facial nerve was identified.
Early specific features of facial nerve development include: 1) intracerebral and peripheral connections with neighboring cranial nerves; 2) intraplexal connections between branches of the parotid plexus; 3) distinguishable intracerebral pathways; 4) connections between the geniculate and vestibular ganglia. Late developmental peculiarities include: 1) progressive macro- and microstructural changes in the geniculate ganglion; 2) appearance of the pes anserinus minor; 3) formation of the motor nucleus, internal knee, and intracerebral pathways. These specific developmental features of the facial nerve provide clear evidence of its complex morphology in adults.