Undivided Retromandibular Vein Leading to the Absence of External Jugular Vein

AbstractWe report a case of undivided retromandibular vein (RV) that was associated with the absence of external jugular vein (EJV). This variation in the jugular venous system was observed on the right side of the neck of a male cadaver. The posterior auricular vein drained into the RV, which joined the facial vein resulting in a common trunk. This common trunk then drained directly into the internal jugular vein (IJV) thus bypassing the whole venous drainage area of the EJV. It is believed that the knowledge about the venous variations, as in the present case, is enlightening to the clinicians. The preoperative evaluation of the venous system is essential to prevent complications like catastrophic bleeding and embolism. The knowledge may guide the emergency physician for a quicker cannulation of the veins.

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Posture-induced changes in the vessels of the head and neck: evaluation using conventional supine CT and upright CT

Scientific Reports ◽

10.1038/s41598-020-73658-0 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Kenzo Kosugi ◽

Yoshitake Yamada ◽

Minoru Yamada ◽

Yoichi Yokoyama ◽

Hirokazu Fujiwara ◽

...

Keyword(s):

Head And Neck ◽

Jugular Vein ◽

Venous Drainage ◽

Craniocervical Junction ◽

External Jugular Vein ◽

Venous System ◽

Upright Posture ◽

Cross Sectional ◽

Postural Changes ◽

The Right

Abstract Since the venous system is affected by gravity, upright computed tomography (CT) in addition to conventional supine CT has great potential for evaluating postural changes in the venous system. We evaluated the morphological differences in the head and neck vessels by performing a contrast CT study in both the supine and the sitting positions. In this study, the 20 included participants (10 men and 10 women) were healthy adults aged 30 to 55 years. The cross-sectional area of the cervical vessels, craniocervical junction veins, and intracranial vessels were obtained quantitatively. Venous sinuses and venous plexuses that were difficult to measure were evaluated qualitatively. The average change in areas from a supine to an upright posture was − 77.87 ± 15.99% (P < 0.0001) in the right internal jugular vein (IJV), − 69.42 ± 23.15% (P < 0.0001) in the left IJV, − 61.52 ± 12.81% (P < 0.0001) in the right external jugular vein (EJV), and − 58.91 ± 17.37% (P < 0.0001) in the left EJV. In contrast, the change in the anterior condylar vein (ACV) from a supine to an upright posture was approximately + 144% (P < 0.005) on the right side and + 110% (P < 0.05) on the left side. In addition, according to the qualitative analysis, the posterior venous structures including the anterior condylar confluence (ACC) of the craniocervical junction became more prominent in an upright posture. Despite these changes, the intracranial vessels showed almost no change between postures. From a supine to an upright position, the IJVs and EJVs above the heart collapsed, and venous channels including the ACCs and ACVs opened, switching the main cerebral venous drainage from the IJVs to the vertebral venous system. Upright head CT angiography can be useful for investigating physiological and pathophysiological hemodynamics of the venous system accompanying postural changes.

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Multiple variations of superficial and deep veins in the neck region of a cadaver: a case report

Anatomy (International Journal of Experimental and Clinical Anatomy) ◽

10.2399/ana.20.753013 ◽

2020 ◽

Vol 14 (2) ◽

pp. 150-155

Author(s):

Nilgün Tuncel Çini ◽

Nazan Güner Sak ◽

Senem Turan Özdemir ◽

İlknur Arı

Keyword(s):

Jugular Vein ◽

Anatomical Variation ◽

Neck Region ◽

External Jugular Vein ◽

Brachiocephalic Vein ◽

Facial Trauma ◽

Common Trunk ◽

Communicating Branch ◽

Male Cadaver ◽

The Right

Multiple variations on the right side of the neck of a 65-year-old male cadaver were observed during a routine dissection. The cadaver had no sign of facial trauma or previous surgery. The facial vein had a communicating branch with the internal jugular vein and distally drained into the jugulo-subclavian confluence via a common trunk with external jugular vein. Other superficial veins of the neck drained into the brachiocephalic vein separately. On the contrary, no anatomical variation was observed on the left side. Even if the variations of the head and neck are common, more than one variation in a single cadaver unilaterally is remarkable. We suggest that it is important for surgeons to examine the patients with ultrasound before any clinical interventions on the neck to determine the possible variations beforehand.

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MULTIPLE VARIATIONS OF THE SUPERFICIAL JUGULAR VEINS: CASE REPORT AND CLINICAL RELEVANCE

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2014.7 ◽

2014 ◽

Vol 57 (1) ◽

pp. 34-37 ◽

Cited By ~ 2

Author(s):

George Paraskevas ◽

Konstantinos Natsis ◽

Orestis Ioannidis ◽

Panagiotis Kitsoulis ◽

Nikolaos Anastasopoulos ◽

...

Keyword(s):

Head And Neck ◽

Jugular Vein ◽

Venous Drainage ◽

Anatomical Variations ◽

Neck Surgery ◽

External Jugular Vein ◽

Venous System ◽

Jugular Veins ◽

The Right ◽

Internal Jugular Veins

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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Termination of the facial vein into the external jugular vein: an anatomical variation

Jornal Vascular Brasileiro ◽

10.1590/s1677-54492008000200015 ◽

2008 ◽

Vol 7 (2) ◽

pp. 174-175 ◽

Cited By ~ 4

Author(s):

Suhani Sumalatha D'Silva ◽

Thejodhar Pulakunta ◽

Bhagath Kumar Potu

Keyword(s):

Jugular Vein ◽

Anatomical Variation ◽

Venous Drainage ◽

External Jugular Vein ◽

Facial Artery ◽

Drainage Pattern ◽

Facial Vein ◽

The Face ◽

The Common ◽

Anterior Division

Different patterns of variations in the venous drainage have been observed in the past. During routine dissection in our Department of Anatomy, an unusual drainage pattern of the veins of the left side of the face of a middle aged cadaver was observed. The facial vein presented a normal course from its origin up to the base of mandible, and then it crossed the base of mandible posteriorly to the facial artery. Thereafter, it joined with the anterior division of retromandibular vein to form the common facial vein, which drained into the external jugular vein directly. Sound anatomic knowledge of the above variation in facial veins is essential to the success of surgical procedures in this region.

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Facial Vein Variation: A Cadaveric Study

International Archives of Medicine ◽

10.3823/2547 ◽

2018 ◽

Vol 11 ◽

Author(s):

Humberto Ferreira Arquez

Keyword(s):

Head And Neck ◽

Jugular Vein ◽

Anatomical Variation ◽

Neck Region ◽

External Jugular Vein ◽

Head And Neck Region ◽

Facial Vein ◽

Variable Distance ◽

The Right ◽

The University

Background: The veins of the head and neck have a complex developmental pattern which predisposes them to variations in formation and drainage. Superficial veins of the head and neck are utilized for central venous cannulation, oral reconstruction and parenteral nutrition in debilitated patients. Clinical and sonological examinations of these veins may provide clues toward underlying cardiac pathology. Aims: The aim of the present study was to describe anatomical variation and determined the position of the facial vein in relation to neighboring structures. Methods and Findings: Head and neck region were carefully dissected as per standard dissection procedure, studied serially during the years 2013-2017 in 16 males and 2 females, i.e. 36 sides, embalmed adults cadavers with different age group, in the laboratory of Morphology of the University of Pamplona. In 34 sides (94.5 %) of the cases the facial vein (FV) terminated into the internal jugular vein via the common facial vein (CFV) as per standard anatomic description. The facial vein on two sides (5.5 %) was found to drain into the external jugular vein with different degree of angulations and variable distance from the angle of the mandible. On the right side, the facial vein was draining into external jugular vein (EJV), 63.6 mm below the angle of the mandible. On the left side, the facial vein was draining into EJV, 42.4 mm below the angle of the mandible. The length of the neck was 137.8 mm. The mean distance of the superior and inferior labial veins, deep facial vein, and angular vein from the inferior orbital margin was 41.89 ± 3.01, 52.31 ± 3.72, 26.85 ± 3.55 and 6.25 ± 0.65 mm, respectively. Conclusion: A sound knowledge on variation of the course and termination of facial vein is very useful for oral and maxillofacial surgeons, plastic surgeons, otorrhinologists and radiologists, is essentially important in the clinical examination and surgical procedures of the head and neck region.

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A macroanatomic study on the facial vein and its branches in the Van cat

Veterinární Medicína ◽

10.17221/1557-vetmed ◽

2011 ◽

Vol 56 (No. 8) ◽

pp. 400-404

Author(s):

HH Ari ◽

Z. Soyguder ◽

S. Cinaroglu ◽

S. Sefergil

Keyword(s):

Lateral Surface ◽

Jugular Vein ◽

Venous Drainage ◽

External Jugular Vein ◽

Research Centre ◽

Domestic Cats ◽

Vein System ◽

Direct Continuation ◽

Facial Vein ◽

The Face

In this study, five adult Van cats of both sexes, which were obtained from the Van Cat Research Centre, were used as materials. After the washing of the veins of the cats with saline via an external jugular vein, latex was injected via the same vessel into the vein system. Then, materials were fixed and after solidification of the latex, the veins were dissected, identified and presented in images. The majority of the venous drainage of the face is done by the facial vein, which is the direct continuation of the linguofacial vein in the intermandibular region, and its branches. In the Van cat, the facial vein gives off the inferior labial vein, the deep facial vein, the angular vein of the mouth and the masseteric branch on the lateral surface of the face. The facial vein then gives off the medial inferior palpebral vein, the superior labial vein and the lateral nasal vein at the level of the levatory nasolabial muscle and the angular vein of the eye and the dorsal nasal vein at the level of medial angle of the eye. The presence of a masseteric branch which is given by the facial vein and the ramifying of the deep facial vein into the descending palatine vein, the anastomotic branch of the superficial temporal vein and the external ophthalmic vein which is given by the deep facial vein in the Van cat demonstrates that there are differences in the presence, ramification and distribution either of the facial vein or of its branches as compared to domestic cats.

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Unusual Venous Drainage Of The Common Facial Vein. A Morphologycal Study

International Archives of Medicine ◽

10.3823/2570 ◽

2018 ◽

Vol 11 ◽

Author(s):

Humberto Ferreira Arquez ◽

Sergio Iván Granados- Torres

Keyword(s):

Internal Jugular Vein ◽

Free Flap ◽

Jugular Vein ◽

Anatomical Variation ◽

Venous Drainage ◽

Brachiocephalic Vein ◽

Facial Vein ◽

The Common ◽

The Right ◽

Internal Thoracic Vein

Background: Anatomical knowledge of the facial vasculature is crucial not only for anatomists but also for oral and maxillofacial surgery, plastic surgeon, otorhinolaryngologists. Access pathways, pedicled and free flap transfer, and explantation and transplantation of total faces are based on the proper assessment and use of the facial veins and arteries. The anatomical variations reported in the present study confirms the need for preoperative vascular imaging for sure good venous outflow for the free flap survival. Aims: The aim of the present study was to describe a rare anatomical variation of the common facial vein which not been previously described. Methods and Findings: Head and neck region were carefully dissected as per standard dissection procedure, studied serially during the years 2013-2017 in 15 males and 2 females, i.e. 34 sides, embalmed adults cadavers with different age group, in the laboratory of Morphology of the University of Pamplona. In 33 sides (97 %) of the cases the anterior facial vein (FV) terminated into the internal jugular vein via the common facial vein (CFV) as per standard anatomic description. The right common facial vein in one side (3%) was found to drain into the contralateral internal thoracic vein and contralateral pericardiophrenic vein. Remarkable communications with the external jugular vein, the internal jugular vein, the anterior jugular vein, and left brachiocephalic vein. The length of the right common facial vein from the level of its formation till its termination in the contralateral pericardiophrenic and internal thoracic vein was about 22.75 cm. The venous drainage pattern on the left side of the face was found to be normal. Conclusion: The existence of this anatomical variation among others supposes a double edge sword in the medical practice with its own opportunities and risks, especially in the surgical treatment; therefore, we need to study with more strictness these possibilities with the aim of facilitate this practices, and improve the life quality of our patients.

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