Trifurcated external carotid artery and complete gamma-loop of its maxillary branch

• Published in: Surgical and radiologic anatomy (English ed.) Vol. 41; no. 2; pp. 231 - 234
• Main Authors: Rusu, Mugurel Constantin, Măru, Nicoleta, Rădoi, Petrinel Mugurel, Dincă, Dănuţ
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.02.2019; Springer Nature B.V
• Subjects: Aged; Anatomic Variation; Anatomic Variations; Anatomy; Carotid arteries; Carotid artery; Carotid Artery, External - anatomy & histology; Carotid Artery, External - diagnostic imaging; Cerebral Angiography; Computed tomography; Computed Tomography Angiography; Contrast Media; Female; Humans; Imaging; Imaging, Three-Dimensional; Intracranial Aneurysm - diagnostic imaging; Iohexol - analogs & derivatives; Mandible; Mandible - blood supply; Maxilla; Maxillary Artery - anatomy & histology; Medicine; Medicine & Public Health; Meningeal Arteries - anatomy & histology; Orthopedics; Parotid gland; Pterygoid Muscles - blood supply; Radiographic Image Interpretation, Computer-Assisted; Radiology; Surgery; Temporal Arteries - anatomy & histology; CT; Mandible; Carotid artery; Maxillary artery; Anatomic variation; Middle meningeal artery
• ISSN: 0930-1038; 1279-8517
• DOI: 10.1007/s00276-018-2142-x

The external carotid artery (ECA) normally bifurcates terminally with the superficial temporal artery (STA) and the maxillary artery (MA). From the horizontally coursing, mandibular segment of the MA leaves the middle meningeal artery (MMA). We hereby report a previously unknown anatomic possibility, incidentally found during an angio-CT scan in an adult female patient. Unilaterally, the ECA was terminally trifurcated, sending off the MA, STA, and MMA. On that side, the mandibular segment of the MA had a gamma-loop and the contralateral one had a U-loop; both these loops were inferior to the lateral pterygoid muscle, closely approaching the respective lingula of the mandible. These findings are relevant during surgery of the parotid gland and infratemporal fossa, approaches of the MMA, and inferior alveolar nerve blocks. The modified origin of the MMA could be explained by an altered development of the primitive stapedial artery.