scholarly journals Preservation of the External Jugular Vein in Bilateral Radical Neck Dissections: Technique in Two Cases and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Rodrigo Lima Bastos da Rocha ◽  
André Del Negro ◽  
Alfio José Tincani ◽  
Maíra Soliani Del Negro ◽  
Antonio Santos Martins
Keyword(s):  
Cerebrospinal Fluid ◽  
Jugular Vein ◽  
Fluid Pressure ◽  
Lymphatic Vessels ◽  
Venous Drainage ◽  
Venous Hypertension ◽  
External Jugular Vein ◽  
Review Of The Literature ◽  
Definitive Therapy ◽  
Facial Edema

Context. The possibility of cephalic venous hypertension with the resultant facial edema and elevated cerebrospinal fluid pressure continues to challenge head and neck surgeons who perform bilateral radical neck dissections during simultaneous or staged procedures.Case Report. The staged procedure in patients who require bilateral neck dissections allows collateral venous drainage to develop, mainly through the internal and external vertebral plexuses, thereby minimizing the risks of deleterious consequences. Nevertheless, this procedure has disadvantages, such as a delay in definitive therapy, the need for a second hospitalization and anesthesia, and the risk of cutting lymphatic vessels and spreading viable cancer cells. In this paper, we discuss the rationale and feasibility of preserving the external jugular vein. Considering the limited number of similar reports in the literature, two cases in which this procedure was accomplished are described. The relevant anatomy and technique are reviewed and the patients’ outcomes are discussed.Conclusion. Preservation of the EJV during bilateral neck dissections is technically feasible, fast, and safe, with clinically and radiologically demonstrated patency.

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

2008 ◽  
Vol 7 (2) ◽  
pp. 174-175 ◽  
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.

Relationship between intracranial pressure and cervical lymphatic pressure and flow rates in sheep

1999 ◽  
Vol 277 (6) ◽  
pp. R1712-R1717 ◽  
Author(s):  
I. Silver ◽  
B. Li ◽  
J. Szalai ◽  
M. Johnston
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Jugular Vein ◽  
Lymphatic Vessels ◽  
Lymph Flow ◽  
Cranial Vault ◽  
Perfusion System ◽  
Flow Rates ◽  
Cisterna Magna ◽  
Mesenteric Lymph

Previous reports from our group demonstrated that about one-half of the total volume of cerebrospinal fluid (CSF) removed from the cranial vault in sheep is transported into extracranial lymphatics, especially cervical lymphatic vessels in the neck. In this study, we tested the hypothesis that an elevation of intracranial pressure (ICP) would increase cervical lymphatic pressure and lymph flow rates in anesthetized sheep. Catheters were inserted into both lateral ventricles, the cisterna magna, cervical lymphatics, and the jugular vein. A ventriculo-cisternal perfusion system was employed to regulate ICP. Mean ( P = 0.008), peak ( P = 0.007), and baseline ( P = 0.013) cervical lymphatic pressures increased as ICP was elevated from 10 to 70 cmH2O in 20-cmH2O increments. Similarly, cervical lymph flow rates increased ( P < 0.001), with flows at 70 cmH2O ICP observed to be approximately fourfold higher than those at 10 cmH2O ICP. No changes were observed in mesenteric lymph flow rates (vessels not expected to drain CSF). We conclude that cervical lymphatic vessels play an important role in the transport of CSF from the cranial vault when ICP is elevated.

Infantile Idiopathic Intracranial Hypertension: A Case Study and Review of the Literature

2019 ◽  
Vol 34 (13) ◽  
pp. 806-814 ◽  
Author(s):  
Sama Boles ◽  
Claudia Martinez-Rios ◽  
Daniel Tibussek ◽  
Daniela Pohl
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Hypertension ◽  
Lumbar Puncture ◽  
Idiopathic Intracranial Hypertension ◽  
Treatment Guidelines ◽  
Fluid Pressure ◽  
Specific Treatment ◽  
Unknown Etiology ◽  
Age Group ◽  
Review Of The Literature

Idiopathic intracranial hypertension, or pseudotumor cerebri, is an increase in cerebrospinal fluid pressure of unknown etiology. It is mostly seen in adults, less frequently in adolescents, rarely in younger children. Only 5 infants meeting idiopathic intracranial hypertension criteria have been mentioned in the literature. We report a case of a previously healthy 9-month-old boy who presented with irritability, decreased appetite, and a bulging fontanelle. Computed tomography (CT) head imaging and cerebrospinal fluid studies revealed normal results. The patient’s symptoms transiently resolved after the initial lumbar puncture, but 11 days later, his fontanelle bulged again. A second lumbar puncture revealed an elevated opening pressure of 35 cmH2O and led to a diagnosis of idiopathic intracranial hypertension in accordance with the modified Dandy Criteria. Treatment with acetazolamide at a dose of 25 mg/kg/d was initiated and the patient remained symptom-free for 6 weeks, followed by another relapse. His acetazolamide dose was increased to 37 mg/kg/d, with no further relapses to date. A diagnosis of idiopathic intracranial hypertension is challenging in infants, because the patients cannot yet verbalize typical idiopathic intracranial hypertension–related symptoms such as positional headaches, diplopia, or pulsatile tinnitus. Furthermore, it is more difficult to assess papilledema in that age group. If undetected and untreated, idiopathic intracranial hypertension may result in permanent visual deficits. Little is known about idiopathic intracranial hypertension in infants, and age-specific treatment guidelines are lacking. We discuss this rare case of infantile idiopathic intracranial hypertension and provide a review of the literature, including an overview of disease characteristics and outcomes of idiopathic intracranial hypertension in this very young age group.

Hearing Loss and Cerebrospinal Fluid Pressure: Case Report and Review of the Literature

2008 ◽  
Vol 87 (3) ◽  
pp. 144-147 ◽  
Author(s):  
Matthew S. Pogodzinski ◽  
Jon K. Shallop ◽  
Juraj Sprung ◽  
Toby N. Weingarten ◽  
Gilbert Y. Wong ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Hearing Loss ◽  
Case Report ◽  
Fluid Pressure ◽  
Cerebrospinal Fluid Pressure ◽  
Review Of The Literature

Superior venous drainage in the “LifeBox”: a portable extracorporeal oxygenator with a self-expanding venous cannula

Perfusion ◽  
2010 ◽  
Vol 25 (4) ◽  
pp. 211-215 ◽  
Author(s):  
Denis Berdajs ◽  
Frank Born ◽  
Monique Crosset ◽  
Judith Horisberger ◽  
Andreas Künzli ◽  
...  
Keyword(s):  
Blood Flow ◽  
Jugular Vein ◽  
Venous Drainage ◽  
External Jugular Vein ◽  
The Self ◽  
Patient Transport ◽  
Drainage Device ◽  
Venous Cannula ◽  
The Common ◽  
Line Pressure

Background: In an experimental setting, the performance of the LifeBox, a new portable extracorporeal membrane oxygenator (ECMO) system suitable for patient transport, is presented. Standard rectilinear percutaneous cannulae are normally employed for this purpose, but have limited flow and pressure delivery due to their rigid structure. Therefore, we aimed to determine the potential for flow increase by using self-expanding venous cannulae. Methods: Veno-arterial bypass was established in three pigs (40.6±5.1 kg). The venous line of the cardiopulmonary bypass was established by cannulation of the external jugular vein. The arterial side of the circulation was secured by cannulation of the common carotid artery. Two different venous cannulae (SmartCanula 18/36F 430mm and Biomedicus 19F) were examined for their functional integrity when used in conjunction with the centrifugal pump (500-3000 RPM) of the LifeBox system. Results: At 1500, 2000, 2500, and 3000 RPM, the blood flow increased steadily for each cannula, but remained higher in the self-expanding cannula. That is, the 19F rectilinear cannula achieved a blood flow of 0.93±0.14, 1.47±0.37, 1.9±0.68, and 1.5±0.9 l/min, respectively, and the 18/36F self-expanding cannula achieved 1.1±0.1, 1.9±0.33, 2.8±0.39 and 3.66±0.52 l/min. However, when tested for venous line pressure, the standard venous cannula achieved -29±10.7mmHg while the self-expanding cannula achieved -13.6 ±4.3mmHg at 1500 RMP. As the RPM increased from 2500 to 3000, the venous line pressure accounted for −141.9±20 and −98±7.3mmHg for the 19F rectilinear cannula and -30.6±6.4 and -45±11.6mmHg for the self-expanding cannula. Conclusion: The self-expanding cannula exhibited superior venous drainage ability when compared to the performance of the standard rectilinear cannula with the use of the LifeBox. The flow rate achieved was approximately 40% greater than the standard drainage device, with a maximal pump flow recorded at 4.3l/min.

scholarly journals Pediatric Patient with Lemierre Syndrome of the External Jugular Vein: Case Report and Literature Review

2021 ◽  
Author(s):  
Yehuda Schwarz ◽  
Nadeem Habashi ◽  
Noa Rosenfeld-Yehoshua ◽  
Eugene Soikher ◽  
Tal Marom ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Jugular Vein ◽  
Management Strategies ◽  
External Jugular Vein ◽  
Review Of The Literature ◽  
Lemierre Syndrome ◽  
Presenting Symptoms ◽  
Intravenous Antibiotics ◽  
Fever Treatment

Abstract Introduction Lemierre syndrome (LS) involving the external jugular vein (EJV) is rare, and only a few cases have been reported in the literature. Objectives To report a case of LS involving the external jugular vein as well as to make a review of the literature regarding both diagnosis and management strategies. Data Synthesis We describe a case of LS involving the EJV and review the literature of previously published articles to search for additional cases. A PubMed, Embase, Scopus, and Web of science-based search was performed to determine the scope of coverage in well-reported articles in English. Twenty-one papers were retrieved and documented for age, incidence, pathogen, presenting symptoms, imaging, treatment, and outcome, which were noted for each of these cases. In our literature review of 21 papers, there were 16 patients (61%) in their 2nd and 3rd decades of life. Lemierre syndrome was shown to affect females and males equally. The presenting symptoms were a sore throat and fever. Treatment requires intravenous antibiotics, and there is no consensus regarding treatment with anticoagulation. Conclusions The present case report and review of the literature emphasize the importance of history taking as well as physical examination in what seems to be a case of simple tonsillitis.

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

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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