一例双侧颈胸血管变异群中的颈总动脉左前喉部血管环：病例报告
Left anterior laryngeal loop of the common carotid artery in a cluster of bilateral cervicothoracic vascular variants: a case report.
文献信息
| PMID | 42955108 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Viviana Dincă |
| 作者单位 | Division of Anatomy, Faculty of Dentistry, "Carol Davila" University of Medicine and Pharmacy, Department 1, 8 Eroilor Sanitari Blvd, Bucharest, 050474, Romania. |
| 期刊 | Surgical and radiologic anatomy : SRA |
| SCI 分区 | Q2 |
| IF | 1.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 颈总动脉（CCA）通常在颈动脉鞘内上行，位于喉和气管的后外侧。前位或气管前位的CCA走行罕见，主要报道于右侧，通常与高位头臂干（BCT）或其他弓部水平异常相关。我们报告一例CTA病例，表现为左侧CCA-BCT共干起源、高位BCT及双侧颈动脉冗长，包括左侧前位喉部CCA血管环。
方法： 采用多平面重建和三维容积渲染重建对主动脉弓及双侧颈动脉系统的CT血管造影（CTA）进行回顾。记录血管环、分支点及其与舌骨-喉框架、甲状腺及邻近骨骼标志的关系。
结果： CTA显示左侧CCA-BCT共干起源，高位BCT测量为3.27 cm。右侧CCA形成1.79 cm的外侧血管环，并在舌骨-喉框架后外侧分叉；右侧颈外动脉（ECA）发出舌面干后形成下颌后血管环。左侧CCA形成2.15 cm的纵隔内血管环和1.75 cm的前位喉部血管环。左侧甲状腺上动脉直接起自CCA。左侧ECA呈独立分支并形成下颌后血管环。迂曲指数范围为33.1%至92.7%；所有节段均迂曲，右侧颈内动脉另形成一处扭结（顶角87.3°）。
结论： 本病例记录了罕见的左侧前位喉部CCA血管环，并伴有双侧颈动脉及颈外动脉分支变异。左侧前位血管环是主要的外科发现，因为它使一条主要颈部动脉靠近前喉部手术野。在实施颈前气道入路、甲状腺手术、喉气管手术及中央颈部操作之前，识别这一模式具有相关性。
英文摘要
PURPOSE: The common carotid artery (CCA) normally ascends in the carotid sheath, posterolateral to the larynx and trachea. Anterior or pretracheal CCA courses are rare and have been described mainly on the right, usually in relation to a high-riding brachiocephalic trunk (BCT) or another arch-level anomaly. We report a CTA case with a common-origin left CCA-BCT trunk, a high-riding BCT and bilateral carotid redundancy, including a left anterior laryngeal CCA loop.
METHODS: Computed tomography angiography (CTA) of the aortic arch and bilateral carotid systems was reviewed using multiplanar reformatting and three-dimensional volume-rendered reconstruction. Vessel loops, branching points and relationships to the hyoid-laryngeal framework, thyroid gland and adjacent skeletal landmarks were recorded.
RESULTS: CTA showed a common-origin left CCA-BCT trunk with a high-riding BCT measuring 3.27 cm. The right CCA formed a 1.79 cm lateral loop and bifurcated posterolateral to the hyoid-laryngeal framework; the right external carotid artery (ECA) gave rise to a linguofacial trunk and then formed a retromandibular loop. The left CCA formed a 2.15 cm intramediastinal loop and a 1.75 cm anterior laryngeal loop. The left superior thyroid artery arose directly from the CCA. The left ECA showed independent branching and a retromandibular loop. Tortuosity indices ranged from 33.1% to 92.7%; all segments were tortuous and the right internal carotid artery additionally formed a kink (apex angle 87.3°).
CONCLUSION: This case documents a rare left anterior laryngeal CCA loop in association with bilateral carotid and external carotid branching variants. The left-sided anterior loop is the main surgical finding because it brings a major cervical artery close to the anterior laryngeal operative field. Recognition of this pattern is relevant before front-of-neck airway access, thyroid surgery, laryngotracheal surgery and central neck procedures.