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Relationship of stylohyoid chain and cervical internal carotid artery detected by 3D angiography

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Abstract

Objective

The calcification of the stylohyoid chain (SHC), elongated styloid process (SP), larger SP’ angle and its shortened distance of cervical internal carotid artery (CICA) are risk factors for bony compression and the stylocarotid syndrome.

Methods

3D-CTAs of 125 patients were analyzed in terms of the SP length, its angulations, type of the SHC and relationships of its proximity to the CICA.

Results

Elongated SP was observed frequently both in females (47%) and males (55%). The mean distance of the CICA to the SP was calculated as 8.2 ± 3.3 mm. This short distance between the CICA and the SP was observed more frequently in males (28.1%) and females (10.7%). The anterior and medial angulations of the SP were calculated as 71.2 ± 4.3°, and 57.3 ± 9.3°, respectively. In the present study, the SHC was determined as normal SP (54.2%), absence of the SP (1%), duplication of the SP (1%), elongated SP (26%), complete ossification of the SHC (1%), segmentation of the SHC (9%), fracture of ossification of the SHC (1.6%) and pseudo articulations of the SHC (5.6%).

Conclusion

3D-CTA was the most appropriate radiological investigation analyzing and measuring SHC (elongated, larger angle, shorter distances with CICA) and identifying types (duplicated, segmented, complete and fractured) resulting from pressures on the CICA. Our study also revealed the pressure on the artery not only arose from the tip of the SP but could also result from types stretching over the artery wall. In those specimens, there is a higher probability of formation of the stylocarotid syndrome due to the long-term pressure on the sympathetic chain around the CICA.

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Ege University, Izmir, Turkey

    Cenk Eraslan & Cem Calli

  2. Department of Anatomy, Faculty of Medicine, Ege University, 35100, Izmir, Turkey

    Mehmet Asim Ozer & Figen Govsa

  3. Faculty of Medicine, Ege University, Izmir, Turkey

    Ahmet Kemal Alagoz

Authors
  1. Cenk Eraslan
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  2. Mehmet Asim Ozer
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  3. Figen Govsa
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  4. Ahmet Kemal Alagoz
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  5. Cem Calli
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Corresponding author

Correspondence to Figen Govsa.

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Ethical standards and patient consent

This study was approved by the ethics committee of Ege University (approval date and number: 27 March 2012; 12-4/6). We declare that this human study has been approved by the ethics committee of Ege University and has, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study. We declare that this manuscript does not contain clinical studies or patient data.

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The authors declare that they have no conflicts of interest.

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Eraslan, C., Ozer, M.A., Govsa, F. et al. Relationship of stylohyoid chain and cervical internal carotid artery detected by 3D angiography. Surg Radiol Anat 39, 897–904 (2017). https://doi.org/10.1007/s00276-017-1812-4

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  • DOI: https://doi.org/10.1007/s00276-017-1812-4

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