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Anomalous innominate artery complicating tracheal surgical procedures

Published online by Cambridge University Press:  25 January 2021

J J E Sargunaraj ,
R R Paul ,
S S Mathews  and
R R A Albert
J J E Sargunaraj
Affiliation:
Department of ENT, Christian Medical College, Vellore632004, Tamil Nadu, India
R R Paul
Affiliation:
Department of ENT, Christian Medical College, Vellore632004, Tamil Nadu, India
S S Mathews
Affiliation:
Department of ENT, Christian Medical College, Vellore632004, Tamil Nadu, India
R R A Albert*
Affiliation:
Department of ENT, Christian Medical College, Vellore632004, Tamil Nadu, India
*
Author for correspondence: Dr Rita Ruby A Albert, Department of ENT, Christian Medical College, Vellore632004, Tamil Nadu, India E-mail: albertrra@yahoo.com Fax: +91 416 228 2288
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Abstract

Objective

To highlight the importance of imaging in reducing an accidental injury to the anomalous brachiocephalic trunk and its branches during tracheal surgery.

Case report

This paper reports two cases of accidental injury to the great vessels in the neck during tracheal surgery. The first incident occurred during a repeat tracheostomy, when the right common carotid artery was injured. On reviewing the computed tomography images, the bifurcation of the brachiocephalic artery was seen to the left of the midline, and the right common carotid artery was adherent just below the tracheostomy site. The second incident happened during surgery for tracheal stenosis, when there was an inadvertent injury to the main brachiocephalic trunk, which was adherent to the trachea in the lower neck region.

Conclusion

For airway surgeons, radiological assessment of vascular structures in relation to the trachea prior to surgery is as important as the endoluminal airway assessment for the best outcome.

Keywords

Brachiocephalic TrunkInnominate ArteryCommon Carotid ArteryTracheal StenosisTracheostomyAccidental Injuries
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 2 , February 2021 , pp. 185 - 188
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr R R Albert takes responsibility for the integrity of the content of the paper

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