The ascending pharyngeal artery is the first or second branch of the external carotid artery, ascending medially to the pharynx between the internal and external carotid arteries. It supplies the pharyngeal wall, the soft palate, the tonsil, the prevertebral muscles, the meninges of the posterior cranial fossa (via pharyngeal meningeal branches through jugular and hypoglossal foramina), and the middle ear.
The ascending pharyngeal artery is a frequent feeding vessel to glomus jugulare and glomus tympanicum tumours, as well as meningiomas of the posterior cranial fossa and paragangliomas. Pre-operative embolisation of the ascending pharyngeal artery reduces intraoperative bleeding during skull base surgery for these vascular tumours. Its meningeal branches through the jugular foramen (inferior tympanic artery) supply the jugular bulb region and the lower cranial nerve territories relevant in jugular foramen surgery.
Glomus jugulare tumour supplied by the ascending pharyngeal artery is embolised 24-48 hours before surgical resection through the infratemporal fossa approach; superselective catheterisation of the ascending pharyngeal artery and particle embolisation devascularises the tumour, reducing intraoperative blood loss from hundreds to tens of millilitres.
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