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Year : 2019  |  Volume : 21  |  Issue : 2  |  Page : 47-51

Aberrant carotid bulb in bilateral tonsillar fossae: An exceptional discovery during tonsillectomy

1 Department of Otorhinolaryngology and Head and Neck Surgery, Al Jahra Hospital, Ministry of Health, Al Jahra, Kuwait
2 Department of ENT, Jahra Hospital, Al Jahra, Kuwait
3 Department of Radiology, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Ramiya Ramachandran Kaipuzha
Department of ENT, Jahra Hospital, Al Jahra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/SJOH.SJOH_5_19

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Tonsillectomy, though a popular surgery, has now downsized to limited indications. Although rare, this surgery may cause trauma to the great vessels leading to life-threatening hemorrhage. The congenitally tortuous internal carotid artery (ICA) is an unusual but important anomaly, especially when it is situated in the tonsillar fossae. About 1%–16% of patients have a surgically vulnerable ICA manifested clinically. Here, we present the first reported case of carotid bulb in the right tonsillar fossa. A 7-year-old female child underwent tonsillectomy for obstructive sleep apnea syndrome. Intraoperatively, she was found to have a carotid bulb in both tonsillar fossae, right more prominent than left one. Computed tomography angiogram confirmed the presence of a prominent carotid bulb in the right tonsillar fossa at the C2level. This case report highlights the importance of a heightened awareness of the anatomic variations of carotid artery, in particular, the carotid bulb. This is of critical significance for a safe tonsillectomy as well as any procedure performed in the oropharyngeal region.

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