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Hypoplastic external jugular vein. Cadaver dissection. Right side, lateral view. 1. great auricular nerve; 2. lesser occipital nerve; 3. angle of mandible; 4. hypoplastic external jugular vein; 5. sternocleidomastoid muscle.
Source publication
(1) Background: The external jugular vein (EJV) descends on the sternocleidomastoid muscle to drain deep into the subclavian vein. Anatomical variations of the EJV are relevant for identification of the greater auricular nerve, flap design and preparation, or EJV cannulation. (2) Methods: Different publications were comprehensively reviewed. Dissec...
Citations
... The anatomic morphology of the EJV may present with considerable variability regarding its origin, course, tributaries and termination. Fenestrations of the EJV have been reported, i.e. the division of the vessel into two branches, which subsequently reunite to form the same vessel again (4,5). Duplication of the EJV, on the other hand, is associated with the division of the vessel and the separate terminating points of its ensuing branches (4). ...
... The EJV may also serve as an alternative for venous outflow in free breast reconstruction, in cases where the internal thoracic vein and the thoracodorsal vein are deemed insufficient for conducting an anastomosis with the donor vessels (4,17). Additionally, the sustenance of the EJV in the reconstruction of defects of the head and neck provides the possibility of harvesting regional flaps, such as the platysma myocutaneous flap, as the venous outflow of the part of the flap is regulated by the internal jugular vein, whereas the EJV drains the posterior part (18). ...
Objective. The external jugular vein drains a considerable part of the head and neck and constitutes a vessel implicated in vari- ous procedures in the cervical region. The aim of this study is to present an uncommon anatomical variation of the external jugular vein, and discuss the clinical implications of its presence. Case Report. We present a rare case of an ectopic external jugular vein terminating into the axillary vein, that we came across during routine dissection of a male cadaver of Greek origin. Conclusion. The venous system of the external jugular vein is used during procedures for the treatment of various conditions such as cardiac arrhythmias, hydrocephalus and defects of the head and neck. Hence, encountering the unpredictable course of a variant draining into the axillary vein may complicate these interventions, leading to multiple manipulations and undesirable results. Surgeons should be aware of the alternate anatomy of the venous system of the cervical region, and mindful of the pos- sibility of encountering them.
... A previous study [5] investigated the internal jugular veins and vertebral epidural venous plexus using this technique, and the results indicated that the vertebral venous plexus was the primary contributor to the intracranial vessels, as previously reported in the literature using other approaches [1-4, 6, 7]. The external jugular tributaries and diploic veins have direct and indirect multiple connections with the internal jugular and prevertebral venous plexus via dural sinuses and subcutaneous veins [11][12][13][14][15]. Therefore, we hypothesise that the contribution of these veins to venous drainage in the head region is also affected by changes in posture. ...
Purpose
Few studies have investigated the influence of posture on the external jugular and diploic venous systems in the head and cranial region. In this study, we aimed to investigate the effects of posture on these systems using upright computed tomography (CT) scanning.
Methods
This study retrospectively analysed an upright CT dataset from a previous prospective study. In each patient, the diameters of the vessels in three external jugular tributaries and four diploic veins were measured using CT digital subtraction venography in both supine and sitting positions.
Results
Amongst the 20 cases in the original dataset, we eventually investigated 19 cases due to motion artifacts in 1 case. Compared with the supine position, most of the external jugular tributaries collapsed, and the average size significantly decreased in the sitting position (decreased by 22–49% on average). In contrast, most of the diploic veins, except the occipital diploic veins, tended to increase or remain unchanged (increased by 12–101% on average) in size in the sitting position compared with the supine position. However, the changes in the veins associated with this positional shift were not uniform; in approximately 5–30% of the cases, depending on each vein, an opposite trend was observed.
Conclusion
Compared to the supine position, the contribution of external jugular tributaries to head venous drainage decreased in the sitting position, whilst most diploic veins maintained their contribution. These results could enhance our understanding of the physiology and pathophysiology of the head region in upright and sitting positions.
... The EJV placement may help paediatricians out. Firstly, the EJV is the largest of the superficial jugular veins, and even in children with difficult vascular access, it is still easy to visualise and palpate [20]. Its localisation and puncture are virtually effortless, as in our study, where its success rate is 100%. ...
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.
