Compression of the cervical internal carotid artery by the stylopharyngeus muscle: An anatomical study with potential clinical significance: Laboratory investigation

R. Shane Tubbs, Marios Loukas, Joshua Dixon, Aaron A. Cohen-Gadol

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Object. Occasionally, the internal carotid artery (ICA) may be symptomatically compressed in the neck by an elongated styloid process. The authors are unaware, however, of any study to date in which the aim was to describe the compression of this part of the ICA by surrounding muscles extending from the styloid process. Methods. In 20 adult cadavers (40 sides), dissection of the cervical ICA was performed, with special attention given to the relationship between this artery and the stylopharyngeus muscle. In addition, rotation of the head was performed while observing for any compression of the ICA by this muscle. Last, the segment of the ICA immediately adjacent to the stylopharyngeus was excised and evaluated for signs of gross compression. Results. Five sides (12.5%) were found to have an ICA that was grossly compressed by the neighboring stylopharyngeus muscle, and this was confirmed on excised ICA specimens. Moreover, such compression was increased with ipsilateral rotation of the head. Effacement of the lumen of the ICA by the stylopharyngeus ranged from approximately 30 to 50%. Such compression was increased by approximately 25% with ipsilateral rotation of the head. Conclusions. To the authors' knowledge, compression of the cervical ICA by the stylopharyngeus muscle has not been previously described. Such a relationship should be appreciated by the clinician who treats patients with symptoms of ICA stenosis or occlusion as a potential extracranial site of compression. Based on this study, a subset of patients with occlusion of the cervical ICA but without elongation of the styloid process should be included within the definition of Eagle syndrome.

Original languageEnglish (US)
Pages (from-to)881-884
Number of pages4
JournalJournal of neurosurgery
Volume113
Issue number4
DOIs
StatePublished - Oct 2010

Fingerprint

Pharyngeal Muscles
Internal Carotid Artery
Muscles
Head
Internal Carotid Artery Dissection
Carotid Stenosis
Cadaver
Neck
Arteries

Keywords

  • Anatomy
  • Carotid artery compression
  • Eagle syndrome
  • Neck pain

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Medicine(all)

Cite this

Compression of the cervical internal carotid artery by the stylopharyngeus muscle : An anatomical study with potential clinical significance: Laboratory investigation. / Tubbs, R. Shane; Loukas, Marios; Dixon, Joshua; Cohen-Gadol, Aaron A.

In: Journal of neurosurgery, Vol. 113, No. 4, 10.2010, p. 881-884.

Research output: Contribution to journalArticle

@article{f01674c499f445a18d9c403e262cfda0,
title = "Compression of the cervical internal carotid artery by the stylopharyngeus muscle: An anatomical study with potential clinical significance: Laboratory investigation",
abstract = "Object. Occasionally, the internal carotid artery (ICA) may be symptomatically compressed in the neck by an elongated styloid process. The authors are unaware, however, of any study to date in which the aim was to describe the compression of this part of the ICA by surrounding muscles extending from the styloid process. Methods. In 20 adult cadavers (40 sides), dissection of the cervical ICA was performed, with special attention given to the relationship between this artery and the stylopharyngeus muscle. In addition, rotation of the head was performed while observing for any compression of the ICA by this muscle. Last, the segment of the ICA immediately adjacent to the stylopharyngeus was excised and evaluated for signs of gross compression. Results. Five sides (12.5{\%}) were found to have an ICA that was grossly compressed by the neighboring stylopharyngeus muscle, and this was confirmed on excised ICA specimens. Moreover, such compression was increased with ipsilateral rotation of the head. Effacement of the lumen of the ICA by the stylopharyngeus ranged from approximately 30 to 50{\%}. Such compression was increased by approximately 25{\%} with ipsilateral rotation of the head. Conclusions. To the authors' knowledge, compression of the cervical ICA by the stylopharyngeus muscle has not been previously described. Such a relationship should be appreciated by the clinician who treats patients with symptoms of ICA stenosis or occlusion as a potential extracranial site of compression. Based on this study, a subset of patients with occlusion of the cervical ICA but without elongation of the styloid process should be included within the definition of Eagle syndrome.",
keywords = "Anatomy, Carotid artery compression, Eagle syndrome, Neck pain",
author = "Tubbs, {R. Shane} and Marios Loukas and Joshua Dixon and Cohen-Gadol, {Aaron A.}",
year = "2010",
month = "10",
doi = "10.3171/2010.1.JNS091407",
language = "English (US)",
volume = "113",
pages = "881--884",
journal = "Journal of Neurosurgery",
issn = "0022-3085",
publisher = "American Association of Neurological Surgeons",
number = "4",

}

TY - JOUR

T1 - Compression of the cervical internal carotid artery by the stylopharyngeus muscle

T2 - An anatomical study with potential clinical significance: Laboratory investigation

AU - Tubbs, R. Shane

AU - Loukas, Marios

AU - Dixon, Joshua

AU - Cohen-Gadol, Aaron A.

PY - 2010/10

Y1 - 2010/10

N2 - Object. Occasionally, the internal carotid artery (ICA) may be symptomatically compressed in the neck by an elongated styloid process. The authors are unaware, however, of any study to date in which the aim was to describe the compression of this part of the ICA by surrounding muscles extending from the styloid process. Methods. In 20 adult cadavers (40 sides), dissection of the cervical ICA was performed, with special attention given to the relationship between this artery and the stylopharyngeus muscle. In addition, rotation of the head was performed while observing for any compression of the ICA by this muscle. Last, the segment of the ICA immediately adjacent to the stylopharyngeus was excised and evaluated for signs of gross compression. Results. Five sides (12.5%) were found to have an ICA that was grossly compressed by the neighboring stylopharyngeus muscle, and this was confirmed on excised ICA specimens. Moreover, such compression was increased with ipsilateral rotation of the head. Effacement of the lumen of the ICA by the stylopharyngeus ranged from approximately 30 to 50%. Such compression was increased by approximately 25% with ipsilateral rotation of the head. Conclusions. To the authors' knowledge, compression of the cervical ICA by the stylopharyngeus muscle has not been previously described. Such a relationship should be appreciated by the clinician who treats patients with symptoms of ICA stenosis or occlusion as a potential extracranial site of compression. Based on this study, a subset of patients with occlusion of the cervical ICA but without elongation of the styloid process should be included within the definition of Eagle syndrome.

AB - Object. Occasionally, the internal carotid artery (ICA) may be symptomatically compressed in the neck by an elongated styloid process. The authors are unaware, however, of any study to date in which the aim was to describe the compression of this part of the ICA by surrounding muscles extending from the styloid process. Methods. In 20 adult cadavers (40 sides), dissection of the cervical ICA was performed, with special attention given to the relationship between this artery and the stylopharyngeus muscle. In addition, rotation of the head was performed while observing for any compression of the ICA by this muscle. Last, the segment of the ICA immediately adjacent to the stylopharyngeus was excised and evaluated for signs of gross compression. Results. Five sides (12.5%) were found to have an ICA that was grossly compressed by the neighboring stylopharyngeus muscle, and this was confirmed on excised ICA specimens. Moreover, such compression was increased with ipsilateral rotation of the head. Effacement of the lumen of the ICA by the stylopharyngeus ranged from approximately 30 to 50%. Such compression was increased by approximately 25% with ipsilateral rotation of the head. Conclusions. To the authors' knowledge, compression of the cervical ICA by the stylopharyngeus muscle has not been previously described. Such a relationship should be appreciated by the clinician who treats patients with symptoms of ICA stenosis or occlusion as a potential extracranial site of compression. Based on this study, a subset of patients with occlusion of the cervical ICA but without elongation of the styloid process should be included within the definition of Eagle syndrome.

KW - Anatomy

KW - Carotid artery compression

KW - Eagle syndrome

KW - Neck pain

UR - http://www.scopus.com/inward/record.url?scp=77957827148&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77957827148&partnerID=8YFLogxK

U2 - 10.3171/2010.1.JNS091407

DO - 10.3171/2010.1.JNS091407

M3 - Article

C2 - 20113161

AN - SCOPUS:77957827148

VL - 113

SP - 881

EP - 884

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

SN - 0022-3085

IS - 4

ER -