Anatomy of Microvascular Anastomosis in the Neck

Abstract

Structural and morphometric investigations of the vessels of the neck region were carried out on 30 cadavers (15 male and 15 female in the age range of 45 to 93 years old) to gain more knowledge of the anatomy for microvascular surgery. Our results briefly are as follows: (1) The non-common-truck type of the external carotid artery (in which each branch arises separately from the external carotid artery) was found in 76.6 percent of cases, the truncus linguofacialis type was found in 21.7 percent, and the truncus thyrolingualis type was found in 1.7 percent. (2) The smallest internal diameter (the average was 1.2 mm) was found in the superficial cervical artery. (3) The largest internal diameter (4.4 mm) was measured in the external carotid artery. (4) The longest arterial section (127.8 mm) was measured between the clavicle and mandibular margin. This vascular section or stem consisted of three parts: the supraclavicular part of the common carotid artery, the proximal section of the external carotid artery, and the first 3 cm of the facial artery. (5) In 46.6 percent of cases, the facial, lingual, and superior thyroid veins joined together and formed a thyrolinguofacialis vein. (6) The type with one external jugular vein accounted for 83.0 percent of cases, and the type with one anterior jugular vein for 67.4 percent of cases. (7) The middle thyroid vein exhibited the smallest internal diameter (average of 2.0 mm). (8) The largest internal diameter (7.9 mm) was measured in the internal jugular vein. (9) The longest vessel to receive a vascular pedicle vein was the external jugular vein, the average length of which was 99.7 mm. (10) The frequency and location of valves in the facial vein were also determined.

CT Angiography for Surgical Planning in Face Transplantation Candidates

“…22 Another critical element of surgical planning is the identification of anatomic variants (Table and Fig 5). 24 Both arteries and veins can have a common trunk, leading to larger caliber vessels compared with the smaller individual vessels. Larger caliber trunks are considered more favorable because the anastomosis is simpler and safer.…”

“…Seventeen percent of individuals have dupli- cated external jugular veins, and 30% of individuals have duplicated anterior jugular veins. 24 As a general rule, 2 venous anastomoses are used to maintain sufficient outflow. Conventional thinking is that compared with the corresponding arteries, selection of drainage veins is considered less critical.…”

Clinical Anatomy of the Maxillary Artery

“…The diameters of cervical blood vessels used as feeding arteries during vascularized free-flap grafting after malignant-tumor resection have been reported sporadically 38,39) . To our knowledge, however, no previous study has measured the luminal diameters of the main trunk of the maxillary artery and its branches.…”

An Unusual Observation During Neck Dissection

“…Superficial venous system is EJV which is formed by union of posterior division of retromandibular vein and posterior auricular vein and runs downward over sternocleidomastoid (SCM) muscle, reaches the roof of posterior triangle and pierces the investing layer of deep cervical fascia and drains into ipsilateral subclavian vein [1]. Shima et al [2] reported 17 % incidence of double EJV where it begins as two veins and joins at the posterior aspect of SCM caudally. Anatomical course of EJV and relationship to the adjacent stable and predictable landmark is important and this knowledge is important in various clinical scenarios.…”