An anatomical road map of the parapharyngeal internal carotid artery in lateral and endoscopic ventral approaches
Objective:To describe the road map of the lateral and endoscopic ventral approaches for the pha-ryngeal segment of the internal carotid artery,propose a sub-segmentation scheme,systematically and compre-hensively understand its anatomical details and relationships with the surrounding structures.Methods:Five fresh cadaveric head specimens(10 sides in total)were dissected through lateral and endoscopic ventral approaches to e-valuate the anatomical details of the parapharyngeal internal carotid artery and its relationship with the surrounding structures.Results:From the bifurcation of the common carotid artery to the vertical part of the internal carotid artery,alongside the direction of blood flow,the parapharyngeal internal carotid artery passes through four dis-tinct anatomical tissues.Based on this,the parapharyngeal internal carotid artery can be divided into four sub-seg-ments:nerve,muscle,fascia and osseous sub-segments.The boundaries and important adjacent structures of each segment are described in detail.Conclusion:The anatomical road map of the parapharyngeal internal carotid artery and the sub-segmentation scheme serving as a practical guide to navigate modular endoscopic skull base sur-gery of the parapharyngeal space while reduce the risk of internal carotid artery injury.
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