The potential for aberrant anatomy in the neck should be respected in order to avoid unexpected and potentially devastating injury during surgical and other procedures. Anatomic variations involving the internal carotid artery are believed to exist in as much as 6% of the population. We describe a case of a tortuous internal carotid artery that was found in zone IIb during a neck dissection in a 60-year-old man, and we discuss the implications of this anomaly.
The expectation of normal anatomy in neck zone IIb-specifically, an absence of vital structures there-might lead a surgeon to overlook the risks of a rapid surgical dissection of nodal and adjacent soft tissue should the patient have aberrant anatomy. As this case report illustrates, the potential for aberrant anatomy throughout the neck should be respected in order to avoid unnecessary injury.