Anomalous branching pattern of the left external carotid artery (ECA) was detected in an old man. The ECA branched into high submental artery and large transverse facial artery ending as angular artery compensating for concurrent agenesis of ipsilateral facial artery. The lingual artery gave direct branch to the submandibular gland, whereas the superior thyroid artery arose directly from common carotid artery with high bifurcation level. This unreported branching pattern of the ECA may have important clinical relevance to cervicofacial surgery.
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