CA Larynx With Lingual Artery Aneurysm Glue Embolisation

A rare condition called postoperative lingual artery pseudoaneurysm coupled with bleeding is typically observed following laryngectomy or tonsillectomy. This study describes the successful use of catheter-directed glue-embolization to treat a symptomatic lingual artery pseudoaneurysm that had developed following the recurrent base of tongue surgeries. Damage to the mouth's floor, particularly iatrogenic trauma from surgical operations, might result in a false aneurysm. This article will detail a case of a lingual artery pseudoaneurysm that developed after tonsillectomy. After a tonsillectomy, lingual artery pseudoaneurysms can develop within a few hours. Endovascular intervention is an effective and low-morbidity alternative to surgery for the treatment of such an aneurysm, and angiography offers the diagnosis. Platinum coil endovascular embolization is a successful technique for managing bleeding and avoiding surgical intervention.  Intervention in the ECA should be a skill set for both neurointerventionists and peripheral interventionists, as many of these circumstances are emergent/urgent or preoperative, in which the procedure is frequently conducted. This review's objective is to present a technical overview of ECA embolization operations, along with their outcomes and potential problems. The extensive range of arteriovenous malformations, in particular cerebral abnormalities involving the dural and cavernous sinuses, are not included in this study because it is restricted to urgent and preoperative cases. Treatment of extracranial arteriovenous malformations of the ECA requires a particular skill set and is outside the purview of this review. Peripheral vascular abnormalities are treated similarly to those in the peripheral circulation. A study of the relevant vascular anatomy will be followed by a detailed explanation of the technical aspects of these operations, and then the review will go on to a discussion of intervention in the specific disease entities. For endovascular therapy to be safe and effective, one must have a thorough understanding of the ECA's anatomy, which is covered in several excellent texts. In 94 percent of patients, the ECA begins at the bifurcation of the internal carotid artery (ICA) and resides anterior to it.  It is best to approach the architecture of the ECA from a functional standpoint because it is extremely varied. Particularly when one artery is tiny, an expanded nearby branch supplies that region. When thinking about endovascular therapy, such variances are crucial. The superior thyroidal artery, which rises anteriorly and travels inferiorly to supply the larynx and thyroid gland, is traditionally thought of as the ECA's initial branch. Rarely does it take part in interventional operations? The lingual artery, which starts anteriorly and divides into a posterior carotid segment and an anterior lingual segment, is the second branch of the ECA. The former provides blood flow to the hypoglossal region, which is crucial for tumors that bleed from the mouth floor from an endovascular perspective. Through the sublingual and deep branches, respectively, the more distal anterior lingual segment also supplies the tongue and the floor of the mouth.  It is important to understand that the terminal distal branches of the lingual artery, the only collateral supply coming from the contralateral lingual artery, are what supply the tongue. Although distal or bilateral embolotherapy is poorly tolerated, endovascular blockage of one branch proximally is well tolerated. The facial artery, which is complex but can be separated into two segments—the submental horizontal and ascending superficial facial segments—is above the lingual artery and also emerges anteriorly. Before continuing to the submandibular region, where it supplies the submandibular gland and the floor of the mouth, the horizontal segment gives branches to the lateral pharynx, the tonsillar region, the hard and soft palates, and other structures. The superficial segment passes through the mandible, crosses it, and then continues forward, supplying branches to the chin, upper, and lower lips. The facial artery typically terminates as the angular artery at the nasolabial fold, which is significant in terms of endovascular communication with the sphenopalatine and ethmoidal vessels, which are particularly relevant in the treatment of epistaxis.  

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