An endoscopic anatomical study of the levator veli palatini and its relationship to the parapharyngeal internal carotid artery

Head Neck. 2020 Aug;42(8):1829-1836. doi: 10.1002/hed.26101. Epub 2020 Feb 11.

Abstract

Background: The objectives of this study are to describe the levator veli palatini (LVP) as a landmark for the parapharyngeal internal carotid artery (pICA) and the endoscopic course of the pICA.

Methods: Cadaver dissection and illustrative case study.

Results: Seven cadaveric heads (12 sides) were dissected. In all 12 sides, the LVP was consistently located between the Eustachian tube and the pICA near the skull base, making the LVP just anterior to and the closest structure to the pICA. The distance between the pICA and the nares ranged from 9.0 to 12.7 cm. The distance between the pICA and the midpoint of the nasopharynx ranged from 1.9 to 3.7 cm. The case study illustrated the applicability of these findings.

Conclusion: The LVP is a reliable and precise landmark for the pICA. A safe working distance to the pICA is 1.9 cm from the midpoint of the nasopharynx and 9.0 cm from the nares.

Keywords: endoscopic surgery; internal carotid artery.

MeSH terms

  • Cadaver
  • Carotid Artery, Internal*
  • Endoscopy
  • Eustachian Tube*
  • Humans
  • Palatal Muscles
  • Skull Base