During surgery of a 56-year-old man for squamous cell carcinoma of neck, the surgeon notices profuse bleeding from deep cervical aery. Which of the following aeries must be ligated immediately to stop bleeding?
**Question:** During surgery of a 56-year-old man for squamous cell carcinoma of neck, the surgeon notices profuse bleeding from deep cervical aery. Which of the following aeries must be ligated immediately to stop bleeding?
A. External carotid artery (ECA)
B. Internal carotid artery (ICA)
C. Vertebral artery (VA)
D. Facial artery (FA)
**Correct Answer:** **D. Facial artery (FA)**
**Core Concept:** Understanding the anatomy and topography of the deep cervical arteries is crucial in identifying and controlling bleeding during neck surgeries, particularly in oncological procedures like neck dissection for squamous cell carcinoma. The deep cervical arteries are part of the carotid artery system and consist of the following branches:
1. **Internal jugular vein (IJV) branch**: This artery is derived from the ECA and supplies the scalp, parotid gland, and deep cervical lymph nodes.
2. **Common facial artery (CFA) branch**: The CFA is derived from the ECA and supplies the skin of the face, oral cavity, and lateral neck.
3. **Superficial temporal artery (STA) branch**: The STA is derived from the external carotid artery (ECA) and supplies the scalp and temporal region.
4. **Facial artery (FA) branch**: The FA is derived from the ECA and supplies the skin of the cheek, buccal mucosa, and oral cavity.
5. **Anterior auricular artery**: This is a branch of the ECA and supplies the skin of the anterior neck.
6. **Vas**: The vas is a branch of the ECA and supplies the skin of the anterior neck.
**Why the correct answer is D. Facial artery (FA)**:
During neck surgery, profuse bleeding from the deep cervical arteries is often caused by injury to the FA, as it supplies the skin of the cheek, buccal mucosa, and oral cavity. Ligating the FA is essential to stop bleeding from the facial region.
**Why other options are incorrect:**
A. Internal jugular vein branch (IJV): Although the IJV is crucial for understanding venous drainage from the head and neck, ligating it would result in severe complications like hemiparesis, hemihypoplasia, and facial nerve palsy due to its close proximity to the facial nerve.
B. Common facial artery (CFA): Ligating the CFA would lead to similar complications as the IJV, due to its close relationship with the facial nerve.
C. Anterior auricular artery (AA): Ligation of the AA would result in severe complications, as it has a close relationship with the facial nerve and supplies blood to the anterior neck.
D. Vas branch: Ligating the Vas would lead to severe complications, as it has a close relationship with the facial nerve and supplies blood to the anterior neck.
In conclusion, when facing profuse bleeding from the deep cervical arteries, the correct choice to control the bleeding is ligating the facial artery (FA). Ligating the FA will stop the bleeding while minimizing the risk