Abstract
Purpose
To determine the relationships between the lingual artery and the lingual markers in tongue resting and extended positions in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) for the clinical application of functional tongue surgery.
Method
Computed tomography angiography (CTA) of the lingual artery was performed on 30 OSAHS patients using a 16-slice spiral CT scanner. The anatomical relationships between the lingual artery and the lingual markers were analyzed with the tongue in resting and extended positions using the CTA images.
Results
The course of the lingual artery resembled the configuration of the Big Dipper constellation when the tongue was in a resting position. When the tongue was in a full-extended position, the majority of the lingual artery moved forward and upward with the hyoid and formed a “√” fashion. The positions of the tip of the greater horn of the hyoid changed with the tongue positions. While the relationship between the main lingual artery and the tip of the greater horn of the hyoid, as well as the distances between bilateral lingual arteries, remained constant in both tongue positions.
Conclusions
In conditions of dynamic tongue movement, the tip of the great horn of the hyoid and the lingual midline are constant anatomical markers to indicate the course of the lingual artery.
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References
Dallan I, Seccia V, Faggioni L et al (2012) Anatomical landmarks for transoral robotic tongue base surgery: comparison between endoscopic, external and radiological perspectives. Surg Radiol Anat. doi:10.1007/s00276-012-0983-2
Handa KK, Shunyu NB (2008) Post traumatic psuedoaneurysm of the lingual artery. Indian J Otolaryngol 60:356–359
Hou Tiening, Shao Jinyan, Fang Songhua (2012) The definition of the V zone for the safety space of functional surgery of the tongue. Laryngoscope 122:66–70
Iwai T, Izumi T, Inoue T et al (2012) Thyrolingual trunk arising from the common carotid artery identified by three-dimensional computed tomography angiography. Surg Radiol Anat 34:85–88
Kakeda S, Korogi Y, Miyaguni Y et al (2008) A cone-beam volume CT using a 3D angiography system with a flat panel detector of direct conversion type: usefulness for superselective intra-arterial chemotherapy for head and neck tumors. AJM Am J Neuroradiol 28:1783–1788
Kimura Y, Ariji Y, Gotoh M et al (2003) Doppler sonography of the deep lingual artery. Acta Radiol 42:309–311
Lauretano AM, Li KK, Caradonna DS et al (1997) Anatomic location of the tongue base neurovascular bundle. Laryngoscope 107:1057–1059
Lell M, Anders K, Uder M et al (2006) New techniques in CT angiography. Radiographics 26:45–62
Lell M, Tomandi BF, Anders K et al (2005) Computed tomography angiography versus digital subtraction angiography in vascular mapping for planning of microsurgical reconstruction of the mandible. Eur Radiol 15:1514–1520
Li KK, Powell NB, Riley RW et al (2002) Temperature controlled radiofrequency tongue base reduction for sleep disordered breathing: long term outcomes. Otolaryngol Head Neck Surg 127:230–234
Li SH, Shi HJ, Wu D et al (2009) Study of lingual arterial CT angiography and security of partial glossectomy in obstructive sleep apnea hypopnea syndrome. Chin J Otorhinolaryngol Head Neck Surg 44:831–836
Lohan DG, Barkhordarian F, Saleh R et al (2007) MR angiography at 3T for assessment of the external carotid artery system. AJR Am J Roentgenol 189:1088–1094
Lopez R, Lauwers F, Paoli JR et al (2007) Vascular territories of the tongue: anatomical study and clinical applications. Surg Radiol Anat 29:239–244
Maturo SC, Mair EA (2007) Submucosal minimally invasive lingual excision (SMILE): technique for tongue base reduction. Oper Tech Otolaryngol 18:29–32
Medical Association Otolaryngology Branch, Chinese Journal of Otolaryngology Editors’ Association (2009) The diagnosis and surgical guidelines of obstructive sleep apnea–hypopnea syndrome. Chin J Otorhinolaryngol Head Neck Surg 44:91–94
Mitra D, Connolly D, Jenkins S et al (2006) Comparison of image quality, diagnostic confidence and interobserver variability in contrast enhanced MR angiography and 2D time of flight angiography in evaluation of carotid stenosis. Brit J Radiol 79:201–207
Múnera F, Soto JA, Nunez D (2004) Penetrating injuries of the neck and the increasing role of CTA. Emerg Radiol 10:303–309
Ye J, Wang J, He L et al (2001) Anatomic characteristics of lingual artery and midline glossectomy. Chin J Otorhinolaryngol 36:55–57
Yonatan L, Eyal R, Zehana H et al (2009) Tongue base ultrasound: a diagnostic tool for predicting obstructive sleep apnea. Ann Otol Rhinol Laryngol 118:179–184
Acknowledgments
The authors wish to thank the staff of Department of Otolaryngology-Head and Neck Surgery and Radiology for their help and cooperation.
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical standard
This study was approved by the Medical Ethics Committee of Zhejiang University School of Medicine. A written, informed consent was obtained from all participants. This study complied with current Chinese laws.
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Hou, Tn., Shao, J., Wang, G. et al. Analysis of the dynamic relationships between the lingual artery and lingual markers in patients with obstructive sleep apnea. Surg Radiol Anat 35, 553–557 (2013). https://doi.org/10.1007/s00276-013-1074-8
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DOI: https://doi.org/10.1007/s00276-013-1074-8