Carotid Artery Medialization in Velocardiofacial Syndrome: Importance of Nasoendoscopy

Velocardiofacial syndrome (VCFS), also known as 22q11.2 deletion syndrome or DiGeorge syndrome, is a complex genetic disorder associated with a spectrum of phenotypic features, including craniofacial anomalies, congenital heart defects, and neurodevelopmental challenges. Among the more concerning, though under-recognized, presentation in VCFS is carotid artery medialization - a finding that places patients at substantial risk for vascular injury during pharyngeal surgeries. This report presents a case of VCFS in which carotid artery medialization was dramatically demonstrated during nasoendoscopic evaluation for velopharyngeal incompetence. The findings underscore the importance of comprehensive preoperative imaging in patients with VCFS to minimize surgical risk and optimize outcomes.