# Novel Variation in the External Carotid Artery: Implications for Clinical and Surgical Practice

## TL;DR

A new variation in the external carotid artery was found during dissection, which could impact surgical and clinical practices involving the head and neck.

## Contribution

The discovery of a novel anatomical variation involving shared origins of multiple arteries in the external carotid artery.

## Key findings

- A common origin for the ascending pharyngeal, facial, and lingual arteries was identified in the external carotid artery.
- Bilateral duplicate ascending pharyngeal arteries were found at the common trunk and carotid bifurcation.
- The variation could lead to misdiagnosis of APA anomalies as internal carotid artery dissections.

## Abstract

The external carotid artery (ECA) is a major branched artery that supplies head and neck structures. An undocumented variation of the ECA was discovered during cadaveric dissection of the anterolateral cervical region, in which a common origin for the ascending pharyngeal, facial, and lingual arteries was identified. In addition, bilateral, duplicate ascending pharyngeal arteries (APAs) were identified at the aforementioned common trunk and the bifurcation of the external and internal carotid arteries. Anatomical knowledge regarding the location of the APA is essential to physicians, as this vessel is a primary supply source for many skull base tumors and vascular lesions. Furthermore, such anatomical knowledge is essential to physicians, as there have been cases of misdiagnosis regarding APA anomalies as an internal carotid artery (ICA) dissection. In this cadaver, both ECAs exhibited typical branching into the superior thyroid artery (STA), occipital artery, posterior auricular artery, maxillary artery, and superficial temporal artery.