A novel Endoscopic Approach to Identify Parapharyngeal Segment of the Internal Carotid Artery

This anatomical study proposes a novel endoscopic approach for the superior part of the parapharyngeal segment of the internal carotid artery. An endoscopic technique involving blunt dissection between the levator veli palatini and the salpingopharyngeal fold was utilized in five fresh-frozen cadavers. Following the excision of the fatty tissue and the incision of the stylopharyngeal fascia, the distances between the levator veli palatini, the salpingopharyngeal fold, the nares, and the parapharyngeal segment of the internal carotid artery at the nasal floor level were measured. The average distance between the posterior edge of the levator veli palatini and the parapharyngeal segment of the internal carotid artery was measured to be 14.4 mm. The salpingopharyngeal fold demonstrated an average distance of 12.4 mm. Furthermore, the mean distance from the nares to the parapharyngeal segment of the internal carotid artery was ascertained to be 89.1 mm. This approach provides a novel method and a different corridor for accessing the parapharyngeal segment of the internal carotid artery, particularly the superior portion located above the nasal base. It emphasizes the levator veli palatini and the salpingopharyngeal fold as critical anatomical landmarks. Fatty tissue and the stylopharyngeal fascia act as protective barriers. Further clinical investigation is necessary to substantiate its practical application in human tissue samples.