Topography of arteries, and veins
Surg Radiol Anat ; 43 11 :Nov. When the computed tomography angiograms of a year-old male were evaluated, extremely rare anatomical variations of both ECAs were found.
This pentafurcation occurred deep to the angle of the mandible and the medial pterygoid muscle, in front of the internal jugular vein. The MA ascended behind the medial pterygoid muscle, deep to the posterior border of the ramus of the topography of arteries and reached the lateral pterygoid muscle to continue normally.
The right internal carotid artery ICA had a lower medial curvature intercalated between the third cervical vertebra and the pharynx. To the authors' knowledge, a terminally pentafurcated ECA has not been previously recorded, and a terminal trifurcation with an added MMA has only been observed once.
Such drastically modified arterial patterns expose the branches emerging from the pentafurcation and pose a risk during surgical approaches within the parotid region. Additionally, a retropharyngeal curvature of the ICA could be subject to compression during deglutition.