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Zhang P, Jia M, Li WY, Li J, Niu JL, Ding H, Zhou WM. Cannulation via the external jugular vein--An alternative to conventional peripherally inserted central catheterisation for paediatric patients. BMC Pediatr 2023; 23:579. [PMID: 37980462 PMCID: PMC10657000 DOI: 10.1186/s12887-023-04403-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/31/2023] [Indexed: 11/20/2023] Open
Abstract
PURPOSE This study aimed to describe a peripherally inserted central catheterisation (PICC) for paediatric patients with inaccessible access and a high risk of general anaesthesia (GA). METHODS This was a retrospective observational study involving all paediatric inpatients who performed the PICC via an EJV approach without GA between September 2014 and September 2021 in a provincial key clinical speciality. RESULTS A total of 290 EJV line placement attempts were performed, and 29 were excluded due to missing placement results, resulting in a sample size of 261. The anatomical localisation, punctures, and catheterisation success rates for this practice were 100%, 100%, and 90.04%, respectively. The placement success rate in children younger than one year was 93.75% (45/48). The median line duration of use was 19 days, with a median length of catheter insertion of 13 cm. The most common complications were catheter malposition (n = 20) and dislodgement (n = 7). CONCLUSION The PICC via an EJV approach without GA is a feasible and safe practice with acceptable success and complication rates, and low costs. It might be an attractive alternative for obtaining central vascular access for paediatric patients.
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Affiliation(s)
- Ping Zhang
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
- Open Fracture and Limb Reconstruction Nursing Professional Committee, Guangdong Nursing Association, Guangzhou, 510170, China
| | - Miao Jia
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
- Open Fracture and Limb Reconstruction Nursing Professional Committee, Guangdong Nursing Association, Guangzhou, 510170, China
| | - Wan-Yuan Li
- Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Juan Li
- Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Jin-Lei Niu
- Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Hong Ding
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Wang-Mei Zhou
- Department of Emergency, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
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2
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Papes D, Cavar S. External jugular vein pseudoaneurysm in a 2-year-old child. J Vasc Surg Venous Lymphat Disord 2023; 11:1288. [PMID: 37863552 DOI: 10.1016/j.jvsv.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 10/22/2023]
Affiliation(s)
- Dino Papes
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Stanko Cavar
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
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3
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Farlow JL, McCrary HC, Li M, Old MO. Internal jugular vein reconstruction: An algorithm for reconstructive surgeons. Oral Oncol 2023; 145:106523. [PMID: 37499330 DOI: 10.1016/j.oraloncology.2023.106523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVES The internal jugular vein (IJV) provides critical drainage from the brain, skull, and deep regions of the face and neck. Compromise to the bilateral IJVs has severe sequelae, but even unilateral IJV sacrifice or thrombosis after treatment can have sequelae. Despite the potential role of IJV reconstruction for head and neck surgeons, information about the indications, technique, and outcomes of the procedure are sparse. PATIENTS AND METHODS We present a woman who had IJV sacrifice for an oral cavity cancer along with a contralateral selective neck dissection and adjuvant chemoradiation who developed occlusion of the contralateral IJV after her treatment, resulting in unacceptable cervical lymphedema and extensive neck varicosities. An end-to-side bypass from the superior IJV to the ipsilateral external jugular vein was performed. RESULTS There were no complications from the procedure, which resulted in dissipation of her preoperative symptoms. We describe the literature surrounding IJV reconstruction, considerations for its use, the technique itself, and advice for perioperative management. CONCLUSION IJV reconstruction is a valuable but underutilized technique for the head and neck microvascular surgeon in cases of bilateral threatened IJV outflow.
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Affiliation(s)
- Janice L Farlow
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Hilary C McCrary
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, UT, USA
| | - Michael Li
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Matthew O Old
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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Bandlamuri S, Khan AS, Bialowas C. Surgical approach to internal and external jugular venous agenesis: case report. Surg Radiol Anat 2023; 45:989-993. [PMID: 37269413 DOI: 10.1007/s00276-023-03179-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 05/27/2023] [Indexed: 06/05/2023]
Abstract
PURPOSE During reconstructive planning for mandibular resection and reconstruction, it was noted that the left internal and external jugular veins were absent, with a considerable compensatory internal jugular vein present on the contralateral side. METHODS An accidental finding in the CT angiogram of the head and neck was assessed. RESULTS Osteocutaneous fibular free flap is a well-established reconstructive surgery for mandibular defects that can involve anastomosis of the internal jugular vein and its tributaries. A 60-years-old man with intraoral squamous cell carcinoma, initially treated with chemoradiation, developed osteoradionecrosis of his left mandible. The patient then underwent resection of this portion of the mandible with reconstruction by osteocutaneous fibular free flap with virtual surgical planning. During reconstructive planning for the resection and reconstruction, it was noted that the left internal and external jugular veins were absent, and a noteworthy compensatory internal jugular vein was present on the contralateral side. We report a rare case of this combination of anatomical variations within the jugular venous system. CONCLUSION Unilateral agenesis of the internal jugular vein has been reported, but a combined variation with ipsilateral agenesis of the external jugular vein and compensatory enlargement of the contralateral internal jugular vein has, to our knowledge, not been reported on previously. The anatomical variation reported in our study will be useful during dissection, central venous catheter placement, styloidectomy, angioplasty/stenting, surgical excision, and reconstructive surgery.
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Affiliation(s)
| | - Amanda S Khan
- Division of Anatomy, Albany Medical College, Albany, NY, USA
| | - Christie Bialowas
- Division of Plastic and Reconstructive Surgery, Albany Medical Center, Albany, NY, USA
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5
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Paraskevas GK, Asouhidou I, Anastasopoulos N, Chrysanthou C, Iliou K, Galanis N, Apostolidi E, Poutoglidis A. External Jugular Vein Perforation by the Transverse Cutaneous Nerve of The Neck: A Case Report and Review of The Literature. Indian J Otolaryngol Head Neck Surg 2023; 75:1173-1176. [PMID: 37275061 PMCID: PMC10235264 DOI: 10.1007/s12070-022-03419-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 12/13/2022] [Indexed: 01/11/2023] Open
Abstract
A very rare anatomical variation of external jugular vein's penetration by the transverse cutaneous nerve of the neck is displayed in the current study. The phenomenon of veins' fenestration or penetration by other structures, such as nerves along with its likely embryologic development are discussed. Moreover, the potential clinical significance of that variation's awareness on behalf the physician is discussed in detail.
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Affiliation(s)
- George K. Paraskevas
- Department of Anatomy and Surgical Anatomy, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Irene Asouhidou
- Department of Anatomy and Surgical Anatomy, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Anastasopoulos
- Department of Anatomy and Surgical Anatomy, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Chrysanthos Chrysanthou
- Department of Anatomy and Surgical Anatomy, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kaliopi Iliou
- Department of Anatomy and Surgical Anatomy, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nektarios Galanis
- Department of Anatomy and Surgical Anatomy, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Elpida Apostolidi
- Department of Anatomy and Surgical Anatomy, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Poutoglidis
- Department of Otorhinolaryngology-Head and Neck Surgery, “G. Papanikolaou” General Hospital, Thessaloniki, Greece
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Ankolekar VH, Hosapatna M, Quadros LS, Sumalatha S, Souza AD. Variation in the formation of the retromandibular and the external jugular veins with embryological overview: A case report. Heliyon 2023; 9:e16013. [PMID: 37206009 PMCID: PMC10189376 DOI: 10.1016/j.heliyon.2023.e16013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 05/21/2023] Open
Abstract
Awareness of the formation and termination of the head & neck's superficial vein, such as jugular veins, are imperative for anatomists, surgeons, and radiologists during interventional procedures. We report an uncommon variation in the formation of the retromandibular vein and external jugular vein (EJV) in an embalmed male cadaver's right side. The joining of the facial vein and superficial temporal vein within the parotid gland formed the retromandibular vein (RMV). The anterior division joined with the submental vein forming an anomalous venous trunk. The anomalous vein united with the EJV forming a common trunk in the lower third of the neck and terminated into the subclavian vein. We compared the available literature and justified the embryological development of this rare variation.
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Affiliation(s)
| | | | | | | | - Anne D. Souza
- Corresponding author. Associate Professor Department of anatomy Kasturba Medical College, Manipal. India
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7
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Won HS, Shin JO, Nam SM, Won HJ. Supraclavicular cephalic vein draining into the internal jugular vein via the external jugular vein. Surg Radiol Anat 2023; 45:487-490. [PMID: 36811688 DOI: 10.1007/s00276-023-03109-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 02/13/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE The aim of this study is to report rare anatomical variations of the cephalic vein (CV) in a 77-year-old Korean male cadaver. CASE REPORT On the right upper arm, the CV located lateral to the deltopectoral groove passed anterior to the clavicle at the lateral one-fourth of the clavicle without anastomosis to the axillary vein. It was connected to the transverse cervical and suprascapular veins by two communicating branches in the middle of its course at the neck, and opened into the external jugular vein at its junction with the internal jugular veins. The suprascapular and anterior jugular veins were flowed into the subclavian vein at the jugulo-subclavian venous confluence, and were connected by a short communicating branch. CONCLUSION Detailed knowledge of the variations in the CV is expected to be helpful in decreasing unpredicted injuries and possible postoperative complications when invasive venous access is performed through the CV.
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Affiliation(s)
- Hyung-Sun Won
- Department of Anatomy and Jesaeng-Euise Clinical Anatomy Center, Wonkwang University School of Medicine, Iksan, South Korea
| | - Jeong-Oh Shin
- Department of Anatomy, College of Medicine, Soonchunhyang University, Cheonan, South Korea
| | - Sung Min Nam
- Department of Anatomy and Jesaeng-Euise Clinical Anatomy Center, Wonkwang University School of Medicine, Iksan, South Korea
| | - Hyung-Jin Won
- Department of Anatomy, School of Medicine, Kangwon National University, Chuncheon, South Korea.
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8
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Khanna H, Shouche S, Singh S. Comparative evaluation between external jugular and internal jugular venous catheterization through landmark technique. J Perioper Pract 2023:17504589231154360. [PMID: 36946178 DOI: 10.1177/17504589231154360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND Cannulation of a central vein is crucial in patients for hemodynamic management and when insertion of a peripheral line is not possible. The internal jugular vein is the preferred access site; however, in the case of not being accessible, the second cannulation site of choice is still unclear. The study aimed to access the feasibility of external jugular vein cannulation versus internal jugular vein cannulation in terms of success, cannulation time, number of attempts and complications. MATERIALS AND METHODS In this prospective, randomised double-blinded study, 100 patients received 7Fr size triple-lumen central vein catheter either in the internal jugular vein (n = 50) or external jugular vein (n = 50) through the landmark technique as a part of anaesthetic care in the operation theatre. The number of attempts, cannulation time and incidence of complications in both the techniques were observed and recorded. RESULTS The success rate in internal jugular vein cannulation was 88%, while in the external jugular vein, it was 78% (p = 0.17). The external jugular vein cannulation was comparatively quicker in our study (p = 0.01). Similarly, elevated body mass index did not affect the success rate in the number of cannulations attempts in either group (p = 0.08). In terms of complications, the internal jugular vein group had a total of 20% and the external jugular vein group had 28% complications; however, the complications were more severe in the internal jugular vein group. CONCLUSION Anaesthetists should rethink alternate routes for the insertion of central vein cannulation. The external jugular cannulation route is one of them.
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Affiliation(s)
- Hitesh Khanna
- Department of Anaesthesiology & Critical Care, Armed Forces Medical College, Pune, India
| | - Sachin Shouche
- Department of Cardiothoracic Anesthesia, Military Hospital (CTC), Pune, India
| | - Shalendra Singh
- Department of Anaesthesiology & Critical Care, Armed Forces Medical College, Pune, India
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9
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Mavromatidis K, Athanasios Bakaloudis A, Skandalos I, Kalogiannidou I, Georgoulidou A. A case report on the placement of a temporal dialysis catheter in the femoral artery for emergency dialysis. Caspian J Intern Med 2023; 14:755-759. [PMID: 38024169 PMCID: PMC10646364 DOI: 10.22088/cjim.14.4.755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 04/20/2022] [Accepted: 04/27/2022] [Indexed: 12/01/2023]
Abstract
Background Ensuring vascular access is essential for dialysis patients. This can be achieved through an arteriovenous anastomosis (fistulae), a central venous catheter, or an arteriovenous graft. However, in some cases vascular access to the patient's blood is not possible. Case Presentation A multi-vascular male patient, who had been undergoing dialysis for 17 years, was presented to our renal department. There was no possibility of vascular access to the patient's venous network for dialysis. A peritoneal dialysis catheter was inserted, but it was malfunctioning. An attempt was made to place a HeRO AV Graft, but it did not succeed due to contraindications from the patient's venous network, as shown by the computed tomography. While trying to solve the problem in order to dialyze the patient during his hospitalization, he experienced severe shortness of breath with tachypnea (pulmonary edema), along with acidosis and hyperkalemia. A temporal dialysis catheter was urgently inserted into the left femoral artery and isolated ultrafiltration was performed, and by removing 1500 ml of ultrafiltration, the patient improved significantly. During the subsequent days, he underwent another 11 dialysis sessions using the femoral artery catheter. While he was hospitalized and being dialyzed via the femoral artery, a successful effort was made to catheterize the right external jugular vein, from which he continues to be dialyzed today. Conclusion The patient's treatment through the placement of a temporal dialysis catheter in the femoral artery enabled him to survive. It is our belief that such a solution could be helpful in similar cases.
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Affiliation(s)
| | | | - Ioannis Skandalos
- Department of Surgery, Gen . Hosp. “St. Pavlos”, Thessaloniki, Greece
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10
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Boutakioute B, Benzalim M, Chehboun A, Ouali M, Ganouni NCIE. Spontaneous external jugular vein pseudoaneurysm: A rare cause of neck swelling. Radiol Case Rep 2022; 17:4790-4794. [PMID: 36238217 PMCID: PMC9550843 DOI: 10.1016/j.radcr.2022.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 11/07/2022] Open
Abstract
Pseudoaneurysm of the external jugular vein is a relatively unusual cause of a neck mass caused by the low pressure venous system. Regardless of etiology, spontaneous pseudoaneurysms are extremely rare, and only few cases have been described in literature. They require surgery; however, most patients can be safely discharged with close follow-up with a vascular surgeon. This case demonstrates a 30-year-old man who presented with a non-tender, compressible, left-sided neck mass that enlarged with Valsalva, and intermittent paresthesias. Ultrasound confirmed a cystic mass of unknown etiology containing doppler flow suggesting the diagnosis of an external jugular vein pseudoaneurysm, confirmed by a CT angiogrphy. The patient refused the surgery, and we agreed he was safe for discharge at that time and could follow up with vascular surgery as an outpatient.
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Affiliation(s)
- Badr Boutakioute
- Department of Radiology, Ar-Razi Hospital, Med VI University Hospital Center, Marrakech 40000, Morocco
- Corresponding author.
| | - Meriam Benzalim
- Department of Radiology, Ibn Tofail Hospital, Med VI University Hospital Center, Marrakech 40000, Morocco
| | - Anass Chehboun
- Department of Radiology, Ar-Razi Hospital, Med VI University Hospital Center, Marrakech 40000, Morocco
| | - Meriem Ouali
- Department of Radiology, Ar-Razi Hospital, Med VI University Hospital Center, Marrakech 40000, Morocco
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11
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Adams A, Zaryske LG. External Jugular Vein Peripheral Intravenous Catheters: An Emergency Nurse's Guide. J Emerg Nurs 2022; 48:303-309. [PMID: 35526875 DOI: 10.1016/j.jen.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/19/2021] [Accepted: 01/10/2022] [Indexed: 10/18/2022]
Abstract
Insertion of a peripheral intravenous catheter into the external jugular vein is regularly performed in emergency departments to treat patients with difficult intravenous access. Although emergency nurses are experienced in inserting peripheral intravenous catheters, there is an inconsistent practice and a lack of education and training regarding the insertion of catheters in the external jugular vein. This manuscript provides a practical guide for emergency nurses to care for patients who require an external jugular peripheral intravenous catheter. Key information found in this manuscript includes indications for external jugular intravenous access, the nurse's role in performing external jugular peripheral intravenous catheters, and clinical considerations when caring for patients with an external jugular peripheral intravenous catheter.
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12
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Xiao Z, Wang J. Side-to-Side Microvascular Anastomosis Using Rat Cervical Vessels. World Neurosurg 2021; 157:e188-e197. [PMID: 34626847 DOI: 10.1016/j.wneu.2021.09.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Side-to-side anastomosis is the most challenging anastomosis owing to the difficult intraluminal suturing technique, which requires practice in the microsurgical laboratory before application in patients in the operating room. The objective of this study was to describe 2 side-to-side microvascular anastomosis training models using rat cervical vessels. METHODS Two side-to-side microvascular anastomosis training models, one with rat cervical vessels between bilateral common carotid arteries (CCAs) (CCA-CCA anastomosis) and one with a unilateral CCA and the anterior facial vein of the external jugular vein (EJV) (CCA-EJV anastomosis), were studied. Diameters of CCA and anterior facial vein, distances between temporary clips and length of arteriotomies, and vascular clipping time were recorded. Patency rates were evaluated immediately and 7 days after the procedure. RESULTS Diameters of CCA and anterior facial vein were 1.00-1.20 mm and 1.40-1.80 mm, respectively. A segment of vessel slightly longer than the arteriotomy or venotomy was temporarily clipped; mean lengths between temporary clips in CCA-CCA anastomosis and CCA-EJV anastomosis of 6.48 ± 0.66 mm and 8.02 ± 0.45 mm, respectively, were used in the study. The minimum distance between the corner of the arteriotomy or venotomy and the clip was 1 mm. The mean vascular temporary clipping times in CCA-CCA anastomosis and CCA-EJV anastomosis were 40.05 ± 3.92 minutes and 42.50 ± 4.82 minutes, respectively. Patency rates of 100% were achieved in all anastomoses. CONCLUSIONS CCA-CCA and CCA-EJV side-to-side anastomosis models using rat cervical vessels are feasible and effective side-to-side anastomosis training models.
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Affiliation(s)
- Zongyu Xiao
- Department of Neurosurgery, Affiliated Hospital of Qinghai University, Xining, China.
| | - Ji Wang
- Department of Neurosurgery, Second Affiliated Hospital of Soochow University, Suzhou, China
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13
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Gerard NO, Tubbs RS, Iwanaga J. Duplicated transverse cervical nerve and external jugular vein. Anat Cell Biol 2021; 54:404-406. [PMID: 34031273 PMCID: PMC8493021 DOI: 10.5115/acb.21.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/27/2021] [Accepted: 04/29/2021] [Indexed: 11/27/2022] Open
Abstract
The transverse cervical nerve arises from anterior rami of the second and third cervical spinal nerves via the cervical plexus. We present a case of a left duplicated transverse cervical nerve with a duplicated external jugular vein in a 72-year-old female cadver. The transverse cervical nerve bifurcated into two branches, i.e., superficial and deep branches, lateral to the sternocleidomastoid muscle. The superficial branch ran lateral to the duplicated external jugular vein and gave a cutaneous branch to the area below the great auricular nerve and cutaneous branches to the skin of the neck. The deep branch ran medial to the duplicated external jugular vein, joined the anterior branch of the superficial transverse cervical nerve and cervical branch of the facial nerve, and terminated into the skin. This case adds to the growing data on individual variability that should be considered when operating on the anterolateral neck.
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Affiliation(s)
- Nicholas O Gerard
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Anatomical Sciences, St. George's University, St. George's Grenada.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.,Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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14
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Abstract
INTRODUCTION Aneurysms of the jugular vein system are rare and high clinical suspicion is needed for diagnosis. External jugular vein aneurysms (EJVA) are considered innocent lesions that need treatment mainly for aesthetic reasons. The aim of this systematic review was to present current literature regarding diagnosis and management of EJVAs. METHODS A literature review was conducted through the Pubmed/Medline and Scopus regarding articles referring on EJVA from 2000 to 2020. Using the PRISMA guidelines (Preferred Reporting Items for Systematic reviews and Meta-Analyses), 30 articles were identified, according to inclusion criteria. Demographics, clinical characteristics, etiology, diagnostic imaging, complications, treatment, and histopathological findings were recorded and analyzed. RESULTS Twenty-seven case reports and one case series were identified, including 30 patients and 31 EJVAs. One-third of patients (30.3%) were < 18 years old (mean age 32 years, range 1-72 years) and 54% of them were females. In 51% of the cases, the lesion was characterized as a true aneurysm after histological evaluation. The presence of a soft cervical mass was the most common clinical symptom, while Valsalva maneuver pointed out the presence of an EJVA in 66.7% of patients. Diagnosis was achieved using ultrasonography, computed tomography, or magnetic resonance imaging. Forty-three percent of the patients underwent more than one radiological examination. Twenty patients underwent surgical management. The primary indication of surgical treatment was aesthetic reasons (11/20, 55%). Thrombosis was the most common EJVA complication (11/30, 36.3%). CONCLUSIONS Differential diagnosis of neck mass should include EJVA. High clinical suspicion and adequate imaging are important for diagnosis. Open surgical approach is the more commonly applied therapeutic strategy.
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Affiliation(s)
- Petroula Nana
- Vascular Surgery Department, Larissa University Hospital, University of Thessaly, Larissa, Greece
| | - Eleni Gkrinia
- Otorhinolaryngology Department - Head and Neck Surgery, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Chara Maiou
- Otorhinolaryngology Department - Head and Neck Surgery, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Ourania Karyda
- Otorhinolaryngology Department - Head and Neck Surgery, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Christos Korais
- Otorhinolaryngology Department - Head and Neck Surgery, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Konstantinos Spanos
- Vascular Surgery Department, Larissa University Hospital, University of Thessaly, Larissa, Greece
| | - Georgios Kouvelos
- Vascular Surgery Department, Larissa University Hospital, University of Thessaly, Larissa, Greece
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Ccorahua-Rios MS, Ccahuantico-Choquevilca LA, Bernaola-Sánchez JB, Miranda-Solis F, Choque-Velasquez J. Supraclavicular nerve entrapment by the external jugular vein: An unreported finding. Morphologie 2021; 106:52-55. [PMID: 33483185 DOI: 10.1016/j.morpho.2020.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE We aim to describe the supraclavicular nerve's vascular entrapment by the external jugular vein as an unreported anatomical finding. CASE DESCRIPTION In a routine cadaveric dissection, the superficial emergence of the first division of the left supraclavicular nerve emerged along a duct formed through the external jugular vein. No other vascular or neural anatomical abnormalities were found in the surrounding structures. CONCLUSION This unreported vascular entrapment of the supraclavicular nerve by the external jugular may harbour clinical implications for surgical and endovascular procedures on the external jugular vein and in refractory thoracic and scapular waist pain.
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Affiliation(s)
- M S Ccorahua-Rios
- Laboratorio de anatomía humana, escuela de medicina, universidad nacional de San Antonio Abad del Cusco, Cusco, Peru; Centro nacional de plastinación y técnicas anatómicas, Cusco, Peru.
| | - L A Ccahuantico-Choquevilca
- Laboratorio de anatomía humana, escuela de medicina, universidad nacional de San Antonio Abad del Cusco, Cusco, Peru; Centro nacional de plastinación y técnicas anatómicas, Cusco, Peru.
| | - J B Bernaola-Sánchez
- Laboratorio de anatomía humana, escuela de medicina, universidad nacional de San Antonio Abad del Cusco, Cusco, Peru; Centro nacional de plastinación y técnicas anatómicas, Cusco, Peru.
| | - F Miranda-Solis
- Laboratorio de anatomía humana, escuela de medicina, universidad nacional de San Antonio Abad del Cusco, Cusco, Peru; Centro nacional de plastinación y técnicas anatómicas, Cusco, Peru.
| | - J Choque-Velasquez
- Department of Neurosurgery, Helsinki University Hospital, Topeliuksenkatu 5, 00260 Helsinki, Finland.
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Mehta N, Desai SM, Dhakad V, Patel D, Saldanha E. External Jugular Cutdown Technique for Totally Implantable Venous Access Devices: a Single-Centre Study. Indian J Surg Oncol 2020; 11:418-422. [PMID: 33013121 DOI: 10.1007/s13193-020-01103-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/07/2020] [Indexed: 11/25/2022] Open
Abstract
Chemotherapy drugs are the integral part of cancer treatment. Their administration is optimized by central venous access devices. We present our prospective study of chemoport implantation by external jugular vein cutdown technique. We studied 100 patients who underwent chemoport insertion over a span of 3 years for various solid and haematological malignancies via external jugular vein cutdown method. Outcomes such as type of disease, anaesthesia, choice of venous access, catheter tip position, length of the procedure, time to start chemotherapy and morbidity data were analysed. The Hundred /100 intravenous devices were implanted in 66% females and 33% males. Most common indication was breast cancer (64% of patients). A total of 80% of patients underwent procedure under local anaesthesia. Chemoports were inserted on the right side in 84 and left side in the remaining 16. The average surgical time was 32 min. The overall success rate was 97% with no intraoperative complications. Three postoperative complications were encountered due to displacement of catheter or wound infection. External jugular vein cutdown approach is a safe, reliable method for venous access device implantation. This approach has a high success rate and has minimal complications and can be easily learnt.
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Affiliation(s)
- Nikhil Mehta
- Department of surgical Onology, Sri Aurobindo Institute of Medical Sciences, Bhanwarsala, Indore, 453555 India
| | - Sanjay M Desai
- Department of surgical Onology, Sri Aurobindo Institute of Medical Sciences, Bhanwarsala, Indore, 453555 India
| | - Vinod Dhakad
- Department of surgical Onology, Sri Aurobindo Institute of Medical Sciences, Bhanwarsala, Indore, 453555 India
| | - Dhruv Patel
- Department of surgical Onology, Sri Aurobindo Institute of Medical Sciences, Bhanwarsala, Indore, 453555 India
| | - Elroy Saldanha
- Department of surgical Onology, Sri Aurobindo Institute of Medical Sciences, Bhanwarsala, Indore, 453555 India
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Nana P, Korais C, Mpouronikou A, Lachanas V, Spanos K, Kouvelos G. Management of an external jugular vein aneurysm in a young patient. J Vasc Surg Venous Lymphat Disord 2020; 8:861-3. [PMID: 32321691 DOI: 10.1016/j.jvsv.2020.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/04/2020] [Indexed: 11/22/2022]
Abstract
External jugular vein aneurysm (EJVA) is a rare clinical entity. A 23-year-old man presented with a spontaneous unilateral cervical swelling. Physical examination revealed a soft, nonpulsatile mass at the left supraclavicular region. Color duplex ultrasound combined with computed tomography confirmed the diagnosis of an EJVA. A surgical excision was accomplished without any complications during the early follow-up. EJVA mandates a high index of suspicion in the differential diagnosis of a neck mass. The open surgical approach seems to be a safe and effective therapeutic strategy.
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18
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Ponnambalam SB, Karuppiah DS. Unilateral external jugular vein fenestration with variant anatomy of the retromandibular and facial vein. Anat Cell Biol 2020; 53:117-120. [PMID: 32274258 PMCID: PMC7118259 DOI: 10.5115/acb.19.172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 08/23/2019] [Accepted: 09/09/2019] [Indexed: 11/27/2022] Open
Abstract
External jugular vein (EJV), a significant superficial vein draining head and neck (H&N) region is been increasingly used for cannulation in diverse diagnostic purposes and intravenous therapies. The variant anatomy of formation and draining patterns of EJV and retromandibular veins were reported earlier. In the present case, EJV showed significant variation in one of the male cadaver, during routine H&N dissection. On the left side, a fenestration of EJV was observed and the transverse cutaneous nerve of the neck was passing through the fenestration of the vein. Anatomical knowledge of EJV and retromandibular vein variations as found in this case is important for surgeons performing microvascular surgeries in H&N and also to the radiologists during their conventional radiological procedures like angioplasty, catheterization, and at times of hemodialysis in case of renal failure patients.
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Narita H, Watanabe S, Umemura K, Shimoda H. A detailed pathway and termination of thoracic duct in a Japanese female cadaver with situs inversus totalis. Anat Sci Int 2020; 95:425-428. [PMID: 32077000 DOI: 10.1007/s12565-020-00532-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 02/10/2020] [Indexed: 11/28/2022]
Abstract
Although the thoracic duct (TD) requires special attention during thoracic surgery, to our knowledge, its detailed course in the situs inversus totalis (SIT) case has not been reported. We encountered an 86-year-old Japanese female cadaver with SIT during a student anatomical practice and examine the TD. The TD originated from the cisterna chyli at the level of the 2nd lumbar vertebra, ascended along with the left side of aorta and then passed behind the aortic arch on the right side of the esophagus. The TD turned right at the first thoracic vertebra and finally emptied into the basal portion of the right external jugular vein without branching. The present running pathway of the TD was approximately in the inverted position of the normal, but its connection site to the vein and manner was very rare and has not been reported to date. Therefore, this junctional anomaly may occur during the developmental period in SIT. Further anatomical and embryological studies are required, but this report provides useful morphogenetic information of the TD and lymphovenous junction in SIT.
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Affiliation(s)
- Hirokazu Narita
- Department of Anatomical Science, Hirosaki University Graduate School of Medicine, 5 Zaifucho, Hirosaki, Aomori, 036-8562, Japan
| | - Seiji Watanabe
- Department of Anatomical Science, Hirosaki University Graduate School of Medicine, 5 Zaifucho, Hirosaki, Aomori, 036-8562, Japan
| | - Kotaro Umemura
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifucho, Hirosaki, Aomori, 036-8562, Japan
| | - Hiroshi Shimoda
- Department of Anatomical Science, Hirosaki University Graduate School of Medicine, 5 Zaifucho, Hirosaki, Aomori, 036-8562, Japan.
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20
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Mohanty CR, Ahmad SR, Jain M, Sriramka B. Air embolism through open hub of external jugular vein intravenous cannula. Turk J Emerg Med 2019; 19:117-119. [PMID: 31321347 PMCID: PMC6612619 DOI: 10.1016/j.tjem.2019.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/08/2019] [Accepted: 06/20/2019] [Indexed: 11/30/2022] Open
Abstract
Introduction Venous air embolism is a catastrophic complication that can result in sudden cardiac arrest and death. Massive air embolism has been reported with central venous catheter through the internal jugular and subclavian veins. Though external jugular vein is a potential site of an air embolism to cardiac chambers and subsequently to vital organs such as brain, heart and lungs but has not been reported yet in literature. Case presentation We are reporting a case of sudden pulmonary air embolism in a patient through the open hub of an intravenous cannula, vigilant monitoring and timely action saved the patient from a catastrophic outcome. Conclusion We recommend vigilant monitoring and adequate precaution in patients with external jugular venous cannulation in the operation theater, intensive care unit or wards to prevent iatrogenic complications.
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Affiliation(s)
- Chitta R Mohanty
- Department of Trauma & Emergency, AIIMS, Bhubaneswar, 751019, India
| | - Suma R Ahmad
- Department of Anaesthesia and Critical Care, AIIMS, Bhubaneswar, 751019, India
| | - Mantu Jain
- Department of Orthopaedics, AIIMS, Bhubaneswar, 751019, India
| | - Bhavna Sriramka
- Department of Anaesthesia and Critical Care, IMS & SUM Hospital, Bhubaneswar, 751003, India
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Abstract
External jugular vein thrombosis is a rare complication that, when it occurs, is usually secondary to cervical trauma, infection, venous cannulation or malignancy. By contrast, spontaneous external jugular thrombosis is extremely uncommon. We report the case of a 69-year-old woman presenting to the Emergency Department with a 3 centimetre neck lump, which had suddenly appeared on the same day. She did not have any other relevant symptoms. The patient had not suffered any recent cervical trauma or infection. There was no personal or familial history of thromboembolic disease. Physical examination was normal, apart from the neck mass. A neck ultrasound revealed a non-occlusive thrombus inside the right external jugular vein. Usual workup, including a coagulation laboratory profile, autoimmunity and malignancy research, was unremarkable, identifying the thrombosis as idiopathic. Anticoagulation treatment was started, leading to a complete resolution of the thrombus, without recurrence. The sudden appearance of a painless cervical mass, without any identified triggering factor, is not common. The possibility of a jugular thrombosis should be kept in mind in the differential diagnosis of an isolated neck lump. In this case, point-of-care ultrasound, which is becoming increasingly available in Emergency Departments, contributed to the rapid and accurate diagnosis of the patient.
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Affiliation(s)
- Carmen Tojo Villanueva
- Service de Médecine Interne, Centre Hospitalier Intercommunal Toulon, La Seyne sur Mer, France
| | - Justo Ruiz Ruiz
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Madrid, Spain
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Vani PC, Rajasekhar SSSN, Gladwin V. Unusual and multiple variations of head and neck veins: a case report. Surg Radiol Anat 2019; 41:535-538. [PMID: 30778672 DOI: 10.1007/s00276-019-02203-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 02/01/2019] [Indexed: 10/27/2022]
Abstract
We report an unusual and multiple variation involving the right head and neck veins which were found during routine dissection in a 50-year-old male cadaver, facial vein draining into both external and internal jugular veins, fenestration in external jugular vein transmitting the supraclavicular nerve trunk, the anterior division of the retromandibular vein draining into anterior jugular vein and the absence of the common facial vein. The knowledge about these variations is important during various surgical and diagnostic procedures involving head and neck region.
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Affiliation(s)
- P C Vani
- Department of Anatomy, JIPMER, Puducherry, India
| | | | - V Gladwin
- Department of Anatomy, JIPMER, Puducherry, India
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Altafulla J, Iwanaga J, Lachkar S, Prickett J, Dupont G, Yilmaz E, Ishak B, Litvack Z, Tubbs RS. The Great Auricular Nerve: Anatomical Study with Application to Nerve Grafting Procedures. World Neurosurg 2019; 125:e403-e407. [PMID: 30703599 DOI: 10.1016/j.wneu.2019.01.087] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/06/2019] [Accepted: 01/08/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND When it comes to autogenous nerve grafting, the sural and great auricular nerve (GAN) are the 2 nerves predominately used for trigeminal and facial nerve repair. Arising from the second and third cervical ventral rami, the GAN emerges from the posterior border of the sternocleidomastoid coursing superiorly and anteriorly toward the ear. METHODS Eleven sides from 5 Caucasian and 1 Asian cadaveric heads (all fresh-frozen) were used. One man and 5 women were used with an age at death ranging from 57 to 91 years, with a mean of 80.3 years. Measurements were made from the inferior border of the ear to the GAN, the GAN to the external jugular vein, and the inferior border of the mastoid process to the GAN; the proximal, medial, and distal diameters of the GAN and the length of the GAN that was obtained from this exposure were also measured. RESULTS The mean distance from the inferior border of the mastoid process to the GAN, inferior border of the ear to the GAN, and GAN to the external jugular vein was 27.71, 31.03, and 13.28 mm, respectively. The mean length of the GAN was 74.86 mm. The mean diameter of its distal, middle, and proximal portions was 1.51, 1.38, and 1.58 mm, respectively. CONCLUSIONS The GAN is an excellent option for use in nerve grafting for repair of, for example, facial dysfunction. In this study, we review our measurements, techniques for identification, and dissecting techniques for the GAN. The proximity to the operative area and minimal complications associated with GAN grafting might contribute to improved patient satisfaction and better outcomes regarding functional restoration.
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Affiliation(s)
- Juan Altafulla
- Seattle Science Foundation, Seattle, Washington, USA; Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA; Neurosurgery Department, Hospital Santo Tomas, Panama
| | - Joe Iwanaga
- Seattle Science Foundation, Seattle, Washington, USA; Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan; Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Japan.
| | | | - Joshua Prickett
- Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA
| | - Graham Dupont
- Seattle Science Foundation, Seattle, Washington, USA
| | - Emre Yilmaz
- Seattle Science Foundation, Seattle, Washington, USA; Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA
| | - Basem Ishak
- Seattle Science Foundation, Seattle, Washington, USA; Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA
| | - Zachary Litvack
- Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA
| | - R Shane Tubbs
- Seattle Science Foundation, Seattle, Washington, USA; Department of Anatomical Sciences, St. George's University, St. George's, Grenada
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Rao S, Pandey S, Kumar Y, Rao S. Bifurcation of external jugular vein: an anatomical variation during neck dissection. Oral Maxillofac Surg 2018; 22:475-476. [PMID: 30167901 DOI: 10.1007/s10006-018-0717-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 08/24/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The pattern of venous drainage of head and neck involves single external jugular vein bilaterally. METHODS AND RESULTS We report a case of bifurcation of the external jugular vein observed during a neck dissection procedure. CONCLUSIONS Anatomical variations in drainage pattern of superficial veins of the head and neck are important for head and neck surgeries including for anastomosis during free tissue transfer for head and neck reconstruction.
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Affiliation(s)
- Santhosh Rao
- Oral & Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences (AIIMS), Raipur, India.
| | - Sameer Pandey
- Oral & Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences (AIIMS), Raipur, India
| | - Yogesh Kumar
- Oral & Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences (AIIMS), Raipur, India
| | - Sruthi Rao
- Oral & Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences (AIIMS), Raipur, India
- Oral & Maxillofacial Surgery, Rungta College of Dental Sciences and Research, Bhilai, India
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Abstract
Given the common and increasing exploitation of superficial head and neck veins in a widening spectrum of clinical and surgical procedures, it is important to equally broaden understanding of the heterogeneity of the vascular anatomy of the region. We report an unusual course of the right common facial vein parallel to the course of external jugular vein, emptying into the ipsilateral subclavian vein in the lateral neck triangle behind the posterior border of the sternocleidomastoid muscle in a 78-year-old male cadaver. Such course may be hazardous for surgical procedures in the region given the high risk of profuse haemorrhage from any injury of the vessel. The variant anatomy may also cause problems in invasive techniques involving the vein, especially in emergency and intensive care settings. This index report, therefore, provides a new insight into the superficial head and neck vein anatomical variations in order to guide relevant clinical procedures in the region.
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Affiliation(s)
- Nejc Umek
- Institute of Anatomy, Faculty of Medicine, University of Ljubljana, Korytkova 2, 1000, Ljubljana, Slovenia.
| | - Erika Cvetko
- Institute of Anatomy, Faculty of Medicine, University of Ljubljana, Korytkova 2, 1000, Ljubljana, Slovenia
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Alshafei A, Tareen F, Maphango N, White D, O'Connor B, Sriparan T. Open tunneled central line insertion in children - External or internal jugular vein? J Pediatr Surg 2018; 53:2318-21. [PMID: 30054059 DOI: 10.1016/j.jpedsurg.2018.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 05/04/2018] [Accepted: 07/05/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND/PURPOSE Tunneled central venous catheters (TCVCs) are commonly used to manage pediatric patients with chronic disease. The aim of this study is to compare the outcomes of external jugular vein (EJV) and internal jugular vein (IJV) tunneled catheters inserted using the open technique. METHODS This is a single institution retrospective analysis of patients requiring an IJV or EJV TCVC in the period between 2009 and 2014. Data collected included the following: patient demographics, site/side of insertion, catheter size, number of lumens, duration of catheter in situ, and complications. RESULTS A total of 942 TCVCs (690 IJV; 252 EJV) were inserted in 761 patients. No statistical difference was seen between the two groups for procedure indications, age, gender, duration of line in situ, side of insertion, catheter size, number of lumens, and rate of premature catheter removals owing to complications. Rates of infection, blockage, and breakage were similar, but dislodgement was higher in the IJV group. EJV access was successful in 91% of attempts. CONCLUSIONS Open EJV TCVC insertion is a safe, quick, and feasible alternative to IJV insertion. EJV access offers comparable outcomes, reduced surgical morbidity, and improved hemostasis especially in children with coagulopathy and/or reduced platelet counts. TYPE OF STUDY Retrospective comparative study. LEVEL OF EVIDENCE Level 3.
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Chapman DR, Ho RE, Gangemi A. A case report of a rare, spontaneous external jugular vein aneurysm. Int J Surg Case Rep 2018; 52:8-10. [PMID: 30300791 PMCID: PMC6175777 DOI: 10.1016/j.ijscr.2018.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/28/2018] [Accepted: 09/05/2018] [Indexed: 11/10/2022] Open
Abstract
Spontaneous external jugular venous (EJV) aneurysms are usually attributed to hypertension or trauma or proximity to high pressure arteries as result of anatomical variation. Spontaneous EJV aneurysms are exceptionally rare but should still be considered in the differential diagnosis of a neck mass. Surgical excision of external jugular venous (EJV) aneurysms should be performed if the condition causes symptoms and/or cosmetic discomfort, to prevent possible and future thrombo-embolic complications and to achieve definitive histopathologic diagnosis.
Introduction Compared to arterial aneurysms, venous pseudoaneurysms are rare and even more rare are external jugular vein aneurysms (EJV). To our knowledge, there are less than 10 well-documented cases of EJV aneurysms accessible. Presentation of case Our patient is a 75 year old hispanic female who noticed a painless right neck mass two months prior. Ultrasound confirmed a cystic mass of unknown etiology containing doppler flow. Excisional biopsy revealed an EJV aneurysm with pathologic results of: blood, calcified debris, and a vessel wall consistent with EJV pseudoaneurysm. Discussion EJV aneurysms are clinically rare compared to IJV aneurysms. Recent trauma, cardiovascular disease and age are reported to be the highest significant clinical risk factors in the formation of jugular vein aneurism (JVA). The absence of trauma in our patient is noteworthy because it eliminates a direct contributor to a normally low-pressure vessel. Conclusions Despite their rarity, spontaneous EJV aneurisms should be included in the differential of the elderly hypertensive patient who is presenting with a painless mass of the lateral neck that has cystic appearance and ultrasound findings of doppler flow.
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Affiliation(s)
- David Ryan Chapman
- Ross University School of Medicine, Department of Surgery, Saint Anthony Hospital, 2875 W 19th St., Chicago, IL 60623, USA
| | - Raymond Elliot Ho
- Ross University School of Medicine, Department of Surgery, Saint Anthony Hospital, 2875 W 19th St., Chicago, IL 60623, USA
| | - Antonio Gangemi
- Department of Surgery - Division of General, Minimally Invasive & Robotic Surgery, University of Illinois at Chicago, 840 S. Wood Street, Suite 435E (M/C958), Chicago, IL 60612, USA.
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Schleimer K, Jalaie H, Afify M, Woitok A, Barbati ME, Hoeft K, Jacobs M, Tolba RH, Steitz J. Sheep models for evaluation of novel patch and prosthesis material in vascular surgery: tips and tricks to avoid possible pitfalls. Acta Vet Scand 2018; 60:42. [PMID: 29976210 PMCID: PMC6034312 DOI: 10.1186/s13028-018-0397-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 06/27/2018] [Indexed: 11/25/2022] Open
Abstract
Background In vascular surgery, novel synthetic prosthesis materials for patch-angioplasties, interpositions, bypasses and shunts are continuously under development and optimization. The characteristics of an ideal vascular prosthesis would display long-term patency, biocompatibility, durability, low porosity, lack of stich hole bleeding, ease of handling, kink resistance, infection resistance and reasonable costs. The aim of this study was to establish and report a reliable sheep model including potential pitfalls where those parameters could be analyzed. Before surgery, sheep were acclimatized for 4–8 weeks, during which parasite infections were treated and blood and serum parameters monitored. Twenty-four sheep underwent surgery, and carotid patch-angioplasties (n = 12), graft interpositions (n = 6) or arteriovenous prosthetic shunts (n = 6) were implanted. Half of the animals in each group were sacrificed after 2 weeks and the other half after 8 weeks. The implants were analyzed for patency, endothelialization, thrombogenicity and biocompatibility by clinical observation, blood flow measurement and pathological and histopathological (H&E, EvG) as well as immunohistochemical (Ki67, CD31) evaluations. Results Health monitoring of the sheep revealed a parasitic burden with endoparasites in all animals. Some animals showed thereby infestations in the bile duct causing fibrotic cholangitis with calcifications in the liver. In addition, sarcosporidia were detected in histopathological specimen of the heart in all animals. Parasitic burden correlated with blood counts and serum bilirubin levels. Both were significantly reduced by albendazole treatment within the acclimatization time. Patches, interposition grafts, and straight shunts were successfully implanted bilaterally in all animals. The total average operation time was 136 ± 21 min. Most animals (23/24) showed good patency rates and general condition after implantation. Pathological and histopathological/immunohistochemical analyses were suitable to determine thrombogenicity, endothelialization, cellular/fibroblastic proliferation, biocompatibility, inflammatory cell infiltration, and thickness of neointima in the prosthesis material. Conclusions We have developed a suitable experimental protocol with standardized and successful anesthesia- and surgical-procedures for patch-angioplasty, graft interposition, and arteriovenous prosthetic shunts. This sheep model allows testing of new prosthetic materials for biocompatibility, thrombogenicity, and endothelialization.
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Araújo RC, Pires LAS, Andrade ML, Perez MC, Filho CSL, Babinski MA. Embryological and comparative description of the cephalic vein joining the external jugular vein: A case report. Morphologie 2018; 102:44-7. [PMID: 29133232 DOI: 10.1016/j.morpho.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/08/2017] [Accepted: 10/10/2017] [Indexed: 11/21/2022]
Abstract
The cephalic vein arises from the radial end of the dorsal venous arch. It turns around the radial border of the forearm and passes proximally along the arm to the shoulder, where it enters the axillary vein by penetrating the clavipectoral triangle. The cephalic vein is prone to vary at the antecubital fossa, where it forms numerous anastomoses. A male cadaver fixated with a 10% formalin solution was dissected during regular anatomy lessons. It was found that the cephalic vein crossed the upper third of the arm between two fasciculi of the deltoid muscle and reached the shoulder, where it passed above the acromion and crossed the posterior border of the clavicle in order to join the external jugular vein. The cephalic vein is one of the most used veins for innumerous activities, such as venipunctures and arteriovenous fistula creation. Furthermore, it is an anatomical landmark known for its consistent anatomy, as it possesses low rates of variability. Despite that, its anatomical variations are clinically and surgically significant and healthcare professionals must be aware of the variations of this vessel. We aim to report a rarely described variation of the cephalic vein and discuss its embryological, phylogenetic and clinical features.
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Cui D, Li J, Zeng G, Zhi X, Du J. A congenital external carotid artery- external jugular vein arteriovenous fistula was successfully treated by coil embolization (case report and literature review). Childs Nerv Syst 2017; 33:1583-1587. [PMID: 28664277 DOI: 10.1007/s00381-017-3488-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 06/08/2017] [Indexed: 11/28/2022]
Abstract
OBJECT Congenital arteriovenous fistula involving the external carotid system is rare. METHODS This paper reports a case of congenital external carotid artery-external jugular vein arteriovenous fistula admitted to Xuanwu Hospital, and reviews the literature. RESULTS The patient was a boy, 9 years old, with a history of pulsatile mass and thrill in the right neck since his birth. External carotid artery-external jugular vein fistula was confirmed by the digital subtraction angio-graphy. And coil embolization was done later. Postoperative immediate angiography confirmed the complete occlusion of the fistula, and partial branch of the external carotid artery can be seen. The abnormal clinical manifestation disappeared after the procedure without any complications. CONCLUSION This case and relevant literatures remind us that congenital external carotid artery-external jugular vein arteriovenous fistula has its unique features, and it can be treated by coil embolization safely and effectively.
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Affiliation(s)
- Deqiu Cui
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Chang Chun St., Beijing, 100053, China
| | - Jingwei Li
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Chang Chun St., Beijing, 100053, China
| | - Gao Zeng
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Chang Chun St., Beijing, 100053, China.
| | - Xinglong Zhi
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Chang Chun St., Beijing, 100053, China
| | - Jianxin Du
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Chang Chun St., Beijing, 100053, China
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Padiyar BV, Azeem Mohiyuddin S, Sagayaraj A, Merchant S. Usefulness of supraclavicular flap in reconstruction following resection of oral cancer. World J Otorhinolaryngol Head Neck Surg 2017; 4:148-152. [PMID: 30101227 PMCID: PMC6074005 DOI: 10.1016/j.wjorl.2017.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 12/29/2016] [Accepted: 01/03/2017] [Indexed: 11/18/2022] Open
Abstract
Objective To evaluate the usefulness of supraclavicular artery flap in reconstruction of defects following resection of buccal mucosa cancer. Methods Twenty-five patients who presented to R.L Jalappa Hospital and Research centre and diagnosed as squamous cell carcinoma of buccal mucosa staged T2 and above were included in our study. All patients underwent wide excision of tumour and neck dissection. Six patients underwent hemi-mandibulectomy while 4 patients underwent marginal mandibulectomy depending on extent of the tumour along with neck dissection. The defect following surgery was reconstructed using the supraclavicular artery flap and were followed up for minimum 6 months during which they were assessed for the functional and aesthetic outcome using a scoring system. The details of the scoring system comprised of 7 attributes. Each attribute was given a score of 10 if the patients experienced that attribute, while a score of 0 was given if the patient did not experience that particular attribute. Results Seven (28%) patients had complete necrosis of the flap. One patient had a local recurrence 2 months following surgery and was lost to follow up. The remaining 17 patients were followed up for a minimum of 6 months and a scoring system was adopted to evaluate the functional and aesthetic outcome of the supraclavicular flap. We observed that 14 patients had an excellent outcome score (58%), 3 patients had a good outcome score (13%), while 7 patients (28%) had flap necrosis. Conclusions We find the supraclavicular flap to be safe, technically simple, sensate, thin, pliable and reliable regional fasciocutaneous flap in reconstructing intra oral defects. Preserving the external jugular vein and sacrificing supraclavicular nerves give good outcome.
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Shetty P, Nayak SB, Thangarajan R, D'Souza MR. A rare case of persistent jugulocephalic vein and its clinical implication. Anat Cell Biol 2016; 49:210-212. [PMID: 27722015 PMCID: PMC5052231 DOI: 10.5115/acb.2016.49.3.210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/17/2016] [Accepted: 08/23/2016] [Indexed: 11/27/2022] Open
Abstract
Persistence of jugulocephalic vein is one of the extremely rare variations of the cephalic vein. Knowledge of such a variation is of utmost importance to orthopedic surgeons while treating the fractures of the clavicle, head and neck surgeons, during surgery of the lower part of neck, for cardiothoracic surgeons and radiologists during catheterization and cardiac device placement. We report the persistent jugulocephalic vein in an adult male cadaver, observed during the routine dissection classes. The right cephalic vein ascended upwards, superficial to the lateral part of the clavicle and terminated into the external jugular vein. It also gave a communicating branch to the axillary vein below the clavicle. We discuss the embryological and clinical importance of this rare variation.
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Affiliation(s)
- Prakashchandra Shetty
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, Inida
| | - Satheesha B Nayak
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, Inida
| | - Rajesh Thangarajan
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, Inida
| | - Melanie Rose D'Souza
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, Inida
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Cavallaro G, Sanguinetti A, Iorio O, D'Ermo G, Polistena A, Avenia N, Silecchia G, De Toma G. Ultrasound-guided vein puncture versus surgical cut-down technique in totally implantable venous access devices (TIVADS): a prospective comparative study on safety, efficacy andcomplications. Int Surg 2014; 99:475-8. [PMID: 25058787 DOI: 10.9738/INTSURG-D-14-00008.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Vinod Kumar G, Ranganatha Reddy B, Bhat SM, Vuppala R. An Intriguing Case of Ectasia of External Jugular Vein Presenting as Intermittent Neck Mass. Indian J Otolaryngol Head Neck Surg 2016; 68:367-9. [PMID: 27508141 DOI: 10.1007/s12070-015-0911-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 09/16/2015] [Indexed: 10/23/2022] Open
Abstract
Ectasia of external jugular vein is a rare entity presenting as an intermittent neck swelling. High index of suspicion is required to diagnose the condition. Ultrasonography with Doppler before, during and after valsalva manoeuvre is the preferred method for diagnosis. The treatment is conservative for asymptomatic patients and surgery is reserved for patients with complications.
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Anehosur V, Rajendiran S, Jayade GR, Kumar N. An Unusual Observation During Neck Dissection. J Maxillofac Oral Surg 2015; 15:306-8. [PMID: 27408458 DOI: 10.1007/s12663-015-0839-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 08/27/2015] [Indexed: 11/30/2022] Open
Abstract
External jugular vein (EJV) is a major superficial vein in the neck which drains deeper parts of face and posterior scalp region. Although it follows a predicted pattern in formation, course and termination in general unusually it also exhibits variations which are clinically important. Gross variations in the incidence of these variations in EJV are noted. We report an anomalous course of EJV which drains into internal jugular vein in our case report. Knowledge about EJV and its origin, course and termination is important for surgeons, interventional radiologist, anaesthesiologist, clinicians in general to avoid inadvertent complication.
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Affiliation(s)
- Venkatesh Anehosur
- SDM Craniofacial Unit, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka India
| | - Saravanan Rajendiran
- SDM Craniofacial Unit, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka India
| | - Gautam R Jayade
- SDM Craniofacial Unit, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka India
| | - Niranjan Kumar
- SDM Craniofacial Unit, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka India
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Anastasopoulos N, Paraskevas G, Apostolidis S, Natsis K. Three superficial veins coursing over the clavicles: a case report. Surg Radiol Anat 2015; 37:1129-31. [PMID: 25681974 DOI: 10.1007/s00276-015-1445-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 02/10/2015] [Indexed: 11/25/2022]
Abstract
We report a unique bilateral combination of multiple variations in the superficial venous system of the neck of a 77-year-old male cadaver. On the right side of the neck, the external jugular vein (EJV) crossed superficial to the lateral third of the clavicle constituting a common trunk with the cephalic vein (CV) that drained into the subclavian vein (SCV). On the left side the EJV descended distally, passed over the anterior surface of the medial third of the clavicle and drained into the SCV. The posterior external jugular vein (PEJV) crossed superficial to the lateral third of the clavicle and terminated into the CV, providing an additional communicating branch to the EJV. Knowledge of both normal and abnormal anatomy of the veins of the neck plays an important role for anesthesiologists or cardiologists doing catheterization, orthopedic surgeons treating clavicle fractures and general surgeons performing head and neck surgery, to avoid inadvertent injury to these vascular structures.
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Affiliation(s)
- Nikolaos Anastasopoulos
- Department of Anatomy, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, P.O. Box 300, 54124, Thessaloniki, Greece
| | - George Paraskevas
- Department of Anatomy, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, P.O. Box 300, 54124, Thessaloniki, Greece
| | - Stylianos Apostolidis
- Department of Anatomy, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, P.O. Box 300, 54124, Thessaloniki, Greece
| | - Konstantinos Natsis
- Department of Anatomy, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, P.O. Box 300, 54124, Thessaloniki, Greece.
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Paraskevas G, Natsis K, Ioannidis O, Kitsoulis P, Anastasopoulos N, Spyridakis I. Multiple variations of the superficial jugular veins: case report and clinical relevance. Acta Medica (Hradec Kralove) 2014; 57:34-7. [PMID: 25006662 DOI: 10.14712/18059694.2014.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The jugular venous system constitutes the primary venous drainage of the head and neck. It includes a profundus or subfascial venous system, formed by the two internal jugular veins, and a superficial or subcutaneous one, formed by the two anterior and two external jugular veins. We report one case of unilateral anatomical variations of the external and anterior jugular veins. Particularly, on the right side, three external jugular veins co-existed with two anterior jugular veins. Such a combination of venous anomalies is extremely rare. The awareness of the variability of these veins is essential to anesthesiologists and radiologists, since the external jugular vein constitutes a common route for catheterization. Their knowledge is also important to surgeons performing head and neck surgery.
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Affiliation(s)
- George Paraskevas
- Department of Anatomy, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Natsis
- Department of Anatomy, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Orestis Ioannidis
- Department of Anatomy, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiotis Kitsoulis
- Department of Anatomy, Histology and Embryology, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Nikolaos Anastasopoulos
- Department of Anatomy, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Spyridakis
- Department of Anatomy, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Patil J, Kumar N, Swamy RS, D'Souza MR, Guru A, Nayak SB. Absence of retromandibular vein associated with atypical formation of external jugular vein in the parotid region. Anat Cell Biol 2014; 47:135-7. [PMID: 24987551 PMCID: PMC4076421 DOI: 10.5115/acb.2014.47.2.135] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 11/13/2013] [Indexed: 11/27/2022] Open
Abstract
Veins of the head and neck exhibiting anatomical variations or malformations are clinically significant. Anatomical variation in the external jugular vein is very common. However, anatomical variation in the retromandibular vein is rare. In this paper, we report a rare case of complete absence of the retromandibular vein. In the absence of the retromandibular vein, the maxillary vein divided into anterior and posterior divisions. The posterior division joined the superficial temporal vein to form an atypical external jugular vein, and the anterior division joined the facial vein to form an anonymous vein. In clinical practice, radiologists and surgeons use the retromandibular vein as a guide to expose the branches of the facial nerve during superficial parotidectomy. Therefore, absence of the retromandibular vein is a hurdle during this procedure and may affect the venous drainage pattern from the head and neck.
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Affiliation(s)
- Jyothsna Patil
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, Karnataka, India
| | - Naveen Kumar
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, Karnataka, India
| | - Ravindra S Swamy
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, Karnataka, India
| | - Melanie R D'Souza
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, Karnataka, India
| | - Anitha Guru
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, Karnataka, India
| | - Satheesha B Nayak
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, Karnataka, India
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Verma RK, Kaushal D, Panda NK. External jugular vein aneurysm with thrombus presenting as painful neck mass: a case report. Oman Med J 2013; 28:278-80. [PMID: 23904923 PMCID: PMC3725242 DOI: 10.5001/omj.2013.77] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 05/29/2013] [Indexed: 11/03/2022] Open
Abstract
External jugular vein aneurysm with thrombosis presenting as neck swelling is a rare clinical entity and rarely encountered in routine clinical practice. We present a case of a 45-year-old female with external jugular vein aneurysm presenting as a painful lump in the neck. Ultrasound of the neck and CT angiography showed saccular dilation of the lower end of the external jugular vein with thrombosis within the aneurysm. Saccular aneurysm of the external jugular vein is very uncommon and can lead to thrombotic complications with serious consequence.
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Affiliation(s)
- Roshan Kumar Verma
- Department of Otolaryngology and Head & Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh-160012, India
| | - Darwin Kaushal
- Department of Otolaryngology and Head & Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh-160012, India
| | - Naresh K. Panda
- Department of Otolaryngology and Head & Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh-160012, India
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Aiyappan SK, Ranga U, Veeraiyan S. Aneurysm of external jugular vein mimicking hemangioma of neck. Indian J Surg 2012; 75:493-5. [PMID: 24465108 DOI: 10.1007/s12262-012-0523-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 05/23/2012] [Indexed: 11/24/2022] Open
Abstract
Venous aneurysms are one of the rare causes of neck swellings. Among neck veins, external jugular vein aneurysms are uncommon. We present a case of a woman who presented with a nontender compressible swelling in the left lower neck region, which initially thought to be hemangioma, was later found to be external jugular vein aneurysm on Doppler ultrasound and CT angiography.
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Affiliation(s)
- Senthil Kumar Aiyappan
- Department of Radiodiagnosis and Imaging, Saveetha Medical College and Hospital, Thandalam, Kancheepuram, Tamilnadu 602105 India
| | - Upasana Ranga
- Department of Radiodiagnosis and Imaging, Saveetha Medical College and Hospital, Thandalam, Kancheepuram, Tamilnadu 602105 India
| | - Saveetha Veeraiyan
- Department of Radiodiagnosis and Imaging, Saveetha Medical College and Hospital, Thandalam, Kancheepuram, Tamilnadu 602105 India
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