Abstract
Background and objectiveIt has long been believed that the bony carotid canal has no plasticity and that a small canal represents a hypoplastic internal carotid artery. We aimed to show whether the carotid canal can narrow according to morphological changes in the internal carotid artery.Materials and methodsThe carotid canal diameter was longitudinally measured in seven individuals who underwent carotid artery ligation. As moyamoya disease is known to be associated with negative remodeling of the internal carotid artery, the carotid canal diameter was measured in 106 patients with moyamoya disease, and an association with the outer diameter of the internal carotid artery or a correlation with the disease stage was investigated. The carotid canal was measured by computed tomography (106 patients), and the outer diameter of the artery was measured by high-resolution magnetic resonance imaging (63 patients). The carotid canal area was calculated by the product of the maximum axial diameter and its perpendicular diameter.ResultsAll seven patients who underwent carotid artery ligation showed narrowing of the carotid canal, and the carotid canal area decreased by 12.2%–28.9% during a mean follow-up period of 4.2 years. In patients with moyamoya disease, the carotid canal area showed a linear correlation with the outer area of the internal carotid artery (r = 0.657, p < 0.001), and a negative correlation with the disease stage (ρ = −0.283, p < 0.001).ConclusionThe bony carotid canal has plasticity, and its area reflects the outer area of the internal carotid artery, therefore, it can be used to assess the remodeling of the carotid artery. A narrow carotid canal may not necessarily indicate hypoplastic internal carotid artery.
Highlights
The bony carotid canal is a passage within the petrous temporal bone that transmits the internal carotid artery (ICA) and sympathetic plexus
The carotid canal was measured by computed tomography (106 patients), and the outer diameter of the artery was measured by high-resolution magnetic resonance imaging (63 patients)
In patients with moyamoya disease, the carotid canal area showed a linear correlation with the outer area of the internal carotid artery (r = 0.657, p < 0.001), and a negative correlation with the disease stage (ρ = −0.283, p < 0.001)
Summary
The bony carotid canal is a passage within the petrous temporal bone that transmits the internal carotid artery (ICA) and sympathetic plexus. Its inferior opening is called the carotid foramen, which is situated anterior to the jugular fossa and medial to the carotid plate. This canal has been recognized as a stable structure that does not change shape; hypoplasia of the bony carotid canal has been used to determine hypoplasia of the ICA [1, 2]. To determine whether the bony carotid canal has plasticity, we measured temporal changes in carotid canal diameter in patients who underwent common carotid artery ligation, which causes atrophy of the ICA. To determine whether carotid canal remodeling occurs even if morphological changes in the ICA are subtle and slow, we selected patients with moyamoya disease (MMD) as a study population. We aimed to show whether the carotid canal can narrow according to morphological changes in the internal carotid artery
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