Evaluation of the Relationship Between Mandibular Condyle and Related Arterial Structures by Computed Tomographic Angiography

Barburoglu M., Emes Y., İŞSEVER H., ÖĞREDEN A., AYBAR B., SENCER S.

The Turkish Journal of Ear Nose and Throat, vol.33, no.1, pp.6-10, 2023 (Peer-Reviewed Journal) identifier


Objective: Iatrogenic injuries of internal maxillary artery (IMA) and external carotid artery (ECA) during temporomandibular and retromandibular region surgeries are serious surgical complications with high mortality and morbidity. In order to avoid this complication, it is important for surgeons to know these vascular structures’ course and their relationship with the mandibular condyle and ramus. The aim of this study was to reveal the relationship of the IMA and ECA with the mandible by head and neck computed tomography (CT) angiography. Materials and methods: Bilateral head and neck CT angiography data in 26 patients (52 region) were evaluated retrospectively. The spatial distance of IMA and ECA to the mandible was calculated in all three planes (IMAx, ECAx, IMAy, ECAy, IMAz, ECAz planes). The presence of vascular tortuosity and contact were also evaluated. Results: We have found that the nearest distance to the ramus of the ECA before giving a branch to IMA was 32.5±7.7 mm above the line drawn tangent to the lower border of corpus mandible. The internal maxillary artery was measured to be in contact with the medial cortical surface of the mandibular condyle in 39 of the 52 angiographies. This contact point was found to be 1.74 mm in front of the posterior margin of the ramus. Conclusion: In this study, we radiologically confirmed that the internal maxillary artery is in close association with the mandibular condyle. It is important for surgeons to be aware of this neighborhood in order to prevent intraoperative vascular injuries.