Jiang SY, Li R. When anatomy becomes pathology: Rethinking carotid-hyoid contact in cerebrovascular events. World J Radiol 2026; 18(2): 116873 [DOI: 10.4329/wjr.v18.i2.116873]
Corresponding Author of This Article
Rui Li, MD, PhD, Professor, Department of Radiology, Affiliated Hospital of North Sichuan Medical College and Sichuan Key Laboratory of Medical Imaging, Maoyuan South Road, Shunqing District, Nanchong 637000, Sichuan Province, China. ddtwg_nsmc@163.com
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Radiology, Nuclear Medicine & Medical Imaging
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Letter to the Editor
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Feb 28, 2026 (publication date) through Feb 28, 2026
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Publication Name
World Journal of Radiology
ISSN
1949-8470
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Jiang SY, Li R. When anatomy becomes pathology: Rethinking carotid-hyoid contact in cerebrovascular events. World J Radiol 2026; 18(2): 116873 [DOI: 10.4329/wjr.v18.i2.116873]
World J Radiol. Feb 28, 2026; 18(2): 116873 Published online Feb 28, 2026. doi: 10.4329/wjr.v18.i2.116873
When anatomy becomes pathology: Rethinking carotid-hyoid contact in cerebrovascular events
Si-Yu Jiang, Rui Li
Si-Yu Jiang, Rui Li, Department of Radiology, Affiliated Hospital of North Sichuan Medical College and Sichuan Key Laboratory of Medical Imaging, Nanchong 637000, Sichuan Province, China
Author contributions: Jiang SY conducted literature analysis and drafted the manuscript; Li R conceptualized the study, and reviewed and finalized the manuscript. All authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Rui Li, MD, PhD, Professor, Department of Radiology, Affiliated Hospital of North Sichuan Medical College and Sichuan Key Laboratory of Medical Imaging, Maoyuan South Road, Shunqing District, Nanchong 637000, Sichuan Province, China. ddtwg_nsmc@163.com
Received: November 24, 2025 Revised: December 9, 2025 Accepted: January 16, 2026 Published online: February 28, 2026 Processing time: 94 Days and 15.2 Hours
Abstract
In this letter, we comment on the recent article by Karangeli et al, which systematically examined the spatial relationship between the hyoid bone and the carotid arteries using computed tomography angiography. The authors revealed significant anatomical variability in the 224 patients in their study, with type VI (external carotid artery lateral to the hyoid) and type VIII (both carotid arteries lateral to the hyoid) being the most common non-null configurations. Notably, sex-based differences were identified, suggesting possible morphometric or biomechanical influences. These findings have important implications for radiologists and surgeons, as non-null variants - particularly types VIII and XI - might predispose to dynamic carotid compression, transient ischemic events, or intraoperative vascular injury. Recognizing these patterns during preoperative imaging can enhance surgical safety and improve the diagnostic evaluation of unexplained cerebrovascular symptoms. The study by Karangeli et al underscores the clinical importance of translating detailed anatomical mapping into preventive strategies that bridge imaging precision and vascular protection.
Core Tip: This letter highlights the clinical importance of recognizing carotid–hyoid spatial variants identified by Karangeli et al. Their computed tomography angiography-based mapping demonstrates that non-null configurations - especially types VIII and XI - are more common than previously reported and may predispose patients to dynamic carotid compression, unexplained cerebrovascular symptoms, or intraoperative vascular injury. Incorporating carotid-hyoid assessment into routine imaging can improve diagnostic accuracy and enhance surgical safety.
