[A topographic anatomical validation of the choice of the approach in reconstructive operations on the extracranial portion of the internal carotid artery].

The purpose of the research was to give a topographical substantiation of the choice of an approach to the extracranial internal carotid artery (ICA) in view of individual anatomical variability of ICA and various localizations of stenosis or occlusion. In 38 human corpses ICA was uncovered using operative methods proposed by Cooper. DePalma, Pauliukas and Nelson. A comparative estimation of the approaches was given with calculation of standard parameters of the operative wound. It was established that the approach to the subcranial ICA was dependent on the type of constitution, features of the anatomical shape of the mandible, distance between the mandibular angle and mastoid process. The statistical processing of the findings has shown that all the factors in question made up 91.5% which is enough for the mathematical description of the position of ICA. Regression models of accessibility of the ICA segment for each of the four investigated approaches were made. The PC program for Windows 95/NT which allows the estimation of accessibility of ICA in each patient before operation was created. These mathematical models were used in the clinic for surgical treatment of the ICA pathology in 24 patients. The difference between the calculated data of ICA accessibility and intraoperative measurements was +/- 3 mm. It demonstrates reliability of the estimation of the approach parameters before operation.