Browsing by Author "Wu, Tai-Ching"

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Effect of carotid artery aberrancy on the distance between the vessel and nasopharyngeal subsites
(2014-05-01)
Lien, Ching-Feng
;
Weng, Hsu-Huei
;
Lin, Bor-Shyh
;
Liu, Ching-Feng
;
Wu, Tai-Ching
Background: Life-threatening hemorrhaging due to nasopharyngeal internal carotid artery (ICA) aberrancy may occur during routine nasopharyngeal surgery. To understand better the potential adverse effect of nasopharyngeal ICA aberrancy on routine nasopharyngeal surgery, we classified aberrant nasopharyngeal ICAs and analyzed the differences in mean distances from the ICA to nasopharyngeal subsites between aberrant and nonaberrant vessels. Methods: The courses of nasopharyngeal ICAs were examined and classified for an aberrant pathway. Various distances were measured on magnetic resonance brain scans. The mean values of the measured variables were compared using an unpaired two-sample t test. Results: The mean distances to the torus tubarius, the opening of Rosenmuller\'s fossa, and the posterior nasopharyngeal wall were 19.6 mm, 15.8 mm, and 16.7 mm, respectively, in the aberrant case group, and 23.1 mm (p < 0.001), 19.8 mm (p < 0.001), and 20.7 mm (p < 0.001) in the nonaberrant control group. Conclusion: The mean distances between the ICA and nasopharyngeal subsites were significantly shortened (by 15-21%) in the presence of aberrant nasopharyngeal segments, which may increase the risk of severe complications in common and uncomplicated nasopharyngeal surgery, such as adenoidectomy, eustachian tuboplasty, and nasopharyngeal biopsies. However, the mean distances were not shortened by the severity (kinking and coiling) of the aberrant nasopharyngeal carotid arteries. Copyright (C) 2014 Elsevier Taiwan LLC and the Chinese Medical Association. All rights reserved.
Risk factors for internal carotid artery injury in adults during simple nasopharyngeal surgeries
(2014-06-01)
Lien, Ching-Feng
;
Weng, Hsu-Huei
;
Liu, Ching-Feng
;
Lin, Bor-Shyh
;
Wu, Tai-Ching
The purpose of this study attempted to analyze the potential risk factors for internal carotid artery injury during simple nasopharyngeal surgeries with or without an endoscopic aid. One hundred and seventy magnetic resonance imaging scans (340 halves) of the brain were retrospectively reviewed and studied. Anatomic variations of carotid arteries were classified, and various distances from the internal carotid arteries to the nasopharyngeal subsites were directly measured on the scans. The mean distances between the internal carotid arteries and nasopharyngeal subsites were significantly shortened in patients with nasopharyngeal internal carotid artery aberrancy, female gender, and lower body weight. The distance to the posterior nasopharyngeal wall was also shortened with age. However, the severity of nasopharyngeal carotid artery variations (kinking and coiling) did not reflect the shortening of mean distances to nasopharyngeal subsites. In conclusion, from multiple linear regression analysis, we found that the risk of an internal carotid artery injury during simple nasopharyngeal surgeries with or without an endoscopic aid is greatest in adult patients with nasopharyngeal carotid artery aberrancy, followed by female gender, lower body weight, and increasing age.