Conclusion
Acknowledgement
Compliance with Ethical Standards
References
which is considered the major blood supply to this region of the fourth branchial arch , have been reported ( Nayak , et al ., 2011 ) and only a few articles have been published on this subject . According to Bergman ’ s Comprehensive Encyclopedia of Human Anatomic Variation , the SLA is expected to branch from the STA and from the LA 88 % and 1 % of the time , respectively , while other origins include the ECA ( 10 %), and a linguo-facial trunk ( 1 %) ( Tubbs , et al ., 2016 ) . Out of 70 hemi-necks , Nayak et al . noted 1 case in which the SLA branched out of the LA and 4 cases from the ECA ( Nayak , et al ., 2011 ) . Similarly , Devadas et al . reported 1 case in which the SLA branched out of the LA and 5 cases from the ECA after their cadaveric study of 60 heminecks ( Devadas , et al ., 2016 ) . As for Vazquez et al ., 9 % of the dissected cadavers showed the SLA coming out of the ECA , while none of the cases related the SLA to the lingual artery ( Vazquez , et al ., 2009 ) . All these published studies agreed that the most frequent branching origin of the SLA is from the STA , and that any variation regarding the SLA is more likely to be unilateral , found more frequently in the left hemi-neck than in the right one ( Vazquez , et al ., 2009 ; Nayak , et al ., 2011 ; Devadas , et al ., 2016 ) , and in males more than in females ( Devadas , et al ., 2016 ) . Actually , Russo et al . classified the type of SLA variation based on the sex of the cadaver in which the variation was found . They noted that the SLA which originated directly from the ECA , superior to the STA , was present more in females ( 38 %) than in males ( 30 %) ( Rusu , et al ., 2007 ) .
In brief , this case report highlights a bilateral variation in the branching origin of the SLA found in a female cadaver , whereby the SLA on each side branches from one of the less frequent origins that have been previously identified ( ECA on right , LA on left ), making it as the first to be report in the field .
Conclusion
The importance of elucidating such variations in the SLA is very relevant during transplants or reconstruction surgeries of the larynx , laryngectomy , chemotherapeutic approaches to laryngeal and hypo laryngeal cancers , or any other surgeries related to the neck area in order to avoid dreadful bleeding complications ( Vazquez , et al ., 2009 ; Nayak , et al ., 2011 ) . Hence , it is important to note that variations regarding the larynx do not involve only the nerve supply , but also the arteries . Variations could be to the right or left , even bilateral , in females , and could follow variable coursing paths and be of different calibers .
Acknowledgement
The authors are thankful for the selfless donation of the body donor .
Compliance with Ethical Standards
The cadaver was treated ethically and the dissection was conducted in accordance with the “ 16th Edition of Grant ’ s Dissector ” instructions .
References
Devadas , D ., Pillay , M . & Sukumaran , T . T ., 2016 . Variations in the Origin of Superior Laryngeal Artery . Anatomy and Cell Biology , pp . 254-258 .
Jurjus , A ., Sfeir , R . & Bezirdjian , R ., 1986 . Unusual Vatiation of the Arterial Pattern of the Human Upper Limb . The Anatomical Record , pp . 82-83 .
Jurjus , A ., Correa-De-Aruaujo , R . & Bohn , R ., 1999 . Bilateral Double Axillary Artery : Embryological Basis and Clinical Implications . Clinical Anatomy , pp . 135-140 .
Nayak , S . R . et al ., 2011 . Variable Origin of the Superior Laryngeal Artery and its Clinical Significance . Al Ameen Journal of Medical Science , 4 ( 1 ), pp . 69-74 .
Rusu , M ., Nimigean , V ., Banu , M . & Niculescu , V ., 2007 . The morphology and topography of the superior laryngeal artery . Sugrical and Radiologic Anatomy , pp . 653-660 .
Tubbs , S . R ., Shoja , M . M . & Loukas , M ., 2016 . Bergman ' s Comprehesive Encyclopedia of Human Anatomic Variations . Hoboken ( New Jersey ): John Wiley & Sons , Inc ..
Vazquez , T . et al ., 2009 . Anatomical variations of the superior thyroid and superior laryngeal arteries . Head and Neck , pp . 1078-1085 .