Anatomy and Histology

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Browsing Anatomy and Histology by Subject "Anatomy -- Variation"

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    Anatomical variation of the carotid bifurcation in a Stellenbosch University cadaver cohort
    (Stellenbosch : Stellenbosch University, 2019-04) Dreyer, Rita Liezl; Page, Benedict; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Biomedical Sciences: Anatomy and Histology.
    ENGLISH ABSTRACT: The carotid bifurcation is the point where the common carotid artery bifurcates into the internal and external carotid artery. A precise anatomical knowledge of the carotid bifurcation is required for various medical specialities. The anatomy of the carotid bifurcation influences the risks, location and prognosis of related pathology. Furthermore, the anatomy of the carotid bifurcation affects treatment as it determines which surgical techniques can be used in an area of high risk. The aim of the study was to determine the anatomical variations of the carotid bifurcation in a Stellenbosch cadaver cohort. One hundred and twenty-eight specimens were examined. This research focuses on the height, angle, general structure, and diameters of the carotid bifurcation, as well as the length and diameter of the carotid sinus. The internal anatomical variation of the carotid bifurcation was added as the study progressed. This study used the gonion as the landmark when measuring height. The Stellenbosch cadaver cohort had a high frequency of high bifurcation with the mean distance of 2.12 cm on the right and 2.06 cm on the left. The angle of bifurcation was 18.53° on the right and 20.24° on the left and was smaller than previous reports in the literature, which ranged between 51-67°. Females had a higher bifurcation and larger angle of bifurcation than males. Sex affected the correlation between angle and height of the bifurcation. The general structure correlated with the standard description and was not influenced by other factors pertaining to the carotid bifurcation, sex or age. Kinks were found in the internal and external carotid artery. The diameters of the carotid bifurcation were larger on the left than on the right. The height of the bifurcation did not influence the probability of kinks in this study, contrary to the literature. The diameters of the internal, external and common carotid arteries in addition to the carotid sinus diameter were larger on the left side and in males. The external carotid had the weakest correlation with the other diameters, which was due to the external carotid artery’s embryological origin. The length of the carotid sinus was 1.74 cm on the right and 1.83 cm on the left. The diameters and the length of the carotid sinus was larger in the males. All external variation slightly increased with age over time as the elasticity of arteries decreased. A variation of the flow diverter was observed in 59% of the cadaver cohort. Supplementary flow diverters were a rare abnormality observed in the internal, external and common carotid arteries. The reason for the carotid bifurcation to present with supplementary flow diverters is still up for debate as this has not been observed in living patients; however, a pathological origin was suggested. Folds in the common carotid were observed. Internal anatomical variation was not affected by external variation or age; however, men had a higher probability of presenting with variation. The Stellenbosch cadaver cohort illustrated variations in the carotid bifurcation which was population-specific. Sex influenced various aspects and correlations of the carotid bifurcation, which means discrepancies can occur and should be considered. Further studies on the carotid bifurcation are needed.