Establishing a danger zone: An anatomic study of the lingual artery in base of tongue surgery
Autor: | David S. Cohen, Sean Mutchnick, Ho-Sheng Lin, Garren M. I. Low, Antoine E. Melkane, Jonathan Waxman, Mahdi A. Shkoukani, Sagar Patel |
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Rok vydání: | 2016 |
Předmět: |
Hypoglossal Nerve
medicine.medical_specialty Lingual artery Lingual Nerve 03 medical and health sciences 0302 clinical medicine Robotic Surgical Procedures Tongue Cadaver medicine.artery Transoral robotic surgery medicine Humans 030223 otorhinolaryngology Lingual papilla Lingual nerve business.industry Arteries Anatomy Palatoglossus muscle Surgery medicine.anatomical_structure Otorhinolaryngology 030220 oncology & carcinogenesis Anatomic Landmarks business Hypoglossal nerve |
Zdroj: | The Laryngoscope. 127:110-115 |
ISSN: | 1531-4995 0023-852X |
Popis: | Objectives/Hypothesis To contrast the changes in measurement of the hypoglossal/lingual artery neurovascular bundle (HLNVB) to constant surface landmarks in the base of tongue (BOT) during surgically simulated retraction versus resting anatomic position, and to identify a safe zone for BOT robotic surgery to avoid injury to the HLNVB. Study Design Human cadaver study. Methods Five fresh-frozen head and neck complexes were obtained, and seven HLNVBs were dissected. A microcaliper was used to measure the distance from the HLNVB to constant surface landmarks in resting and surgically simulated positions using a Feyh-Kastenbauer retractor. Results Measurements from foramen cecum to palatoglossus muscle (P < 0.042) was significantly different when comparing anatomical to surgically simulated positions. Importantly, the location of the lingual artery in reference to the surface landmarks measured was dramatically altered with tongue retraction. With retraction, the branches of the dorsal lingual artery were not encountered posterior to a horizontal line between midway circumvallate papilla (mCVP). Conclusion Measurements of the HLNVB to surface landmarks in the BOT differs significantly between resting and a surgically simulated tongue position. The dorsal branch of the lingual artery seems more superficial in the BOT than previously described. A safe zone may exist posterior to an imaginary horizontal line between mCVP; however, further studies are needed to confirm this. Level of Evidence N/A. Laryngoscope, 2016 |
Databáze: | OpenAIRE |
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