The Branching Angle of the Lingual Artery With Application to Super Selective Intra‐Arterial Chemotherapy: A Cadaveric Study

The lingual artery (LA) is depicted as originating from the anterior wall of the external carotid artery (ECA) as well as the superior thyroid and the facial arteries (FA) in anatomy textbooks and atlases. During super selective intra-arterial chemotherapy to the LA, surgeons empirically rotate the catheter medially but not for other anterior branches of the ECA. This study aimed to quantitatively investigate the degree of the LA at its origin for catheter rotation during super selective intra-arterial chemotherapy. Twenty-six halves from 14 formalin-fixed cadaveric heads were dissected. The origin of the LA and other anterior branches was observed laterally. The ECA was then incised in the axial plane at the origins of the superior and inferior margins of the anterior branches. The angles of the anterior branches in the axial plane were calculated. The relative height of LA compared to the carotid bifurcation and FA origin varied. The LA tended to originate more medially than the other anterior branches of the ECA. The mean angle difference between the LA and the other anterior branches of the ECA was approximately 40°. The LA originating from the linguofacial trunk traveled medially at its origin. The quantitative data provide anatomical evidence for the catheter rotation technique used to access the LA during a super selective intra-arterial chemotherapy.