The wedged position of scalenus anterior between the carotid sheath
and the brachial plexus/scalenus medius will also make differentiating between scalenus anterior and these structures difficult.
The large mass identified on axial imaging was anatomically located within the left anterior cervical space; the boundaries of which are formed by all three layers of the deep cervical fascia before they converge; forming the carotid sheath
posteriorly (1) (Figure.
Most are located anterior to the sternocleidomastoid muscle, posterior to the submandibular gland and lateral to the carotid sheath
CT angiography of the neck demonstrated a heterogeneously enhanced irregular 2.4 x 2.2 x 2.2 cm mass within the right carotid sheath
along the lateral aspect of the proximal internal and external carotid arteries with minimal splaying of these arteries (Figures 1(a), 1(b), and 1(c)).
In the neck, infection spreads from peritonsillar, submandibular, sublingual, lateral pharyngeal and anterior visceral space extending to retropharyngeal, prevertebral and carotid sheath
The carotid artery was draped over the mass, so the carotid sheath
was opened and the artery was mobilized off the front of the mass.
It is expected that these tumours will have the same intrinsic imaging characteristics, as they have the same histological basis, however it is unusual for a vagal paraganglioma to arise within the carotid sheath
at the point of the carotid bifurcation.
When ectopic, parathyroid glands can be located from the carotid sheath
to the mediastinum to the inferior aspect of the heart.
Inferiorly it descends into the neck medial to the carotid sheath
. Posterosuperiorly it communicates with infra temporal fossa.
Then it descends through the neck within the carotid sheath
. Meanwhile, the hypoglossal nerve runs medial to the IXth, Xth, and XIth cranial nerves after its exit from the cranium.
In the normal course a persistent fistula of the second, third and fourth branchial cleft and pouch passes from the external opening in the mid or lower third of neck in the line of the anterior border of the sternocleidomastoid muscle, deep to platysma along the carotid sheath
(1) CT revealed a peripherally enhancing, ovoid tumor posterior to the carotid sheath
The abscess may be drained either via a transoral approach or through the neck.The accepted method is an aspiration and by an incision at the most convex point by the external approach.The abscess is drained in most instances by an incision in front of the stern mastoid muscle, in the plane between the carotid sheath
and the visceral compartment of the neck if the abscess is high in the neck.It is better approached from behind the carotid sheath
through an incision behind the stern mastoid muscle.
In the carotid artery type, symptoms occur when the elongated styloid process stimulates the sympathetic nerves in the carotid sheath
It then ascends along the carotid sheath
, passing over the superior laryngeal nerve, deep to the glossopharyngeal nerve, behind the internal carotid, piercing the thyrohyoid membrane and entering the upper lateral piriform sinus wall (18, 19).