咽升动脉分支的解剖分组及其临床意义

目的:探讨咽升动脉及其主要分支在颈部颅底区域走行规律及其在血管内外治疗中的临床意义。方法:选择以10%甲醛固定并用乳胶灌注的8具（16侧）成人颅颈部标本，自颈总动脉分叉水平向上解剖至颅底骨质，分离显露咽升动脉及周围相关结构，观察咽升动脉的起源部位及主要分支，测量相关解剖学参数。依据咽升动脉主要分支与颈动脉鞘的位置关系分...

Anatomical classification of the ascending pharyngeal artery branches and its clinical implications

Objective To explore the anatomical characteristics of the ascending pharyngeal artery (APA) and the major trunks in the skull base and evaluate the implications. Methods The origin, course, and branching patterns of APA were observed in eight human cadaveric specimens (16 sides), which were fixed in a 10% formalin solution and then injected with colored latex. The relationship between the APA and its surrounding structures were observed. Data were measured and analyzed, focusing on the relationship between the APA and the carotid sheath. Results In 13 sides of the specimens, the APA originated from the external carotid artery, lying inferior to the origin of the facial artery. The APA could originate directly from the occipital artery (two sides) or share a common trunk with the occipital artery in one side. Before the bifurcation into the pharyngeal and meningeal trunks, the mean length of the common trunk of the APA was (15.39 ± 3.20) mm (14 sides). The bifurcation of the APA varied in two sides of the specimens. The meningeal trunk entered the carotid sheath (CS) and extended toward intracranial regions through the hypoglossal canal, jugular foramen, inferior tympanic foramen, and foramen magnum. The mean distance from the origin of the meningeal trunk to the CS was (9.32 ± 3.20) mm. The pharyngeal trunk did not enter the CS but gave rise to arterial arcade surrounding the parapharyngeal and paravertebral spaces. The major branches of the APA were classified into two groups. Intra-CS group included the meningeal trunk and inferior tympanic artery, which coursed into the CS medially to the internal carotid artery (ICA). Extra-CS group was composed of the pharyngeal trunk and muscular branches, which did not enter the CS. Conclusions The APA and its branches have significant variation and complicated course. They could be divided into groups according to the positional relationship between the main branches of the APA and the CS. The clinical application value of using CS as an anatomic marker to make individualized intravascular and extravascular treatment plan for patients with head and neck lesions remains to be proved.