The lingual-facial-ascending pharyngeal trunk

Though small, the ascending pharyngeal artery (APA) is surgically significant due to its proximity to the internal carotid artery (ICA) and supply to critical neurovascular structures. We present a unique arterial variant identified by computed tomography angiography (CTA) in a 52-year-old male. On the left side, the APA originated in common with a short linguofacial trunk (LFT) that further gave rise to the lingual and facial arteries (LA and FA), forming a trifurcated LA-FA-APA trunk. On the right side, an independent LFT was present, with the APA originating separately from the external carotid artery (ECA). CTA with three-dimensional reconstruction is essential for detecting rare vascular configurations and should be part of the preoperative evaluation for head and neck surgeries and endovascular procedures.