Evaluation of the External Jugular Vein Overlying the Sternocleidomastoid Muscle as Venous Lymph-Node Flap

Abstract

Background: Until recently, vascularized lymph-node flaps were based on arterial and venous donor vessels. Now, venous lymph-node flaps form a novel promising concept in the treatment of advanced-stage lymphedema. In preliminary studies, the external jugular vein has shown promising results as a venous lymph-node flap. However, nothing is known about the number of lymph nodes adjacent to the external jugular vein. Methods: Standardized specimens of the external jugular vein and surrounding fatty tissue directly overlying the sternocleidomastoid muscle were obtained during routine neck dissection. Histologic evaluation was performed in order to evaluate for the presence of lymph nodes within the tissue. Results: A total of 20 specimens were evaluated. There was no vein in 4 of the samples. We found lymph nodes in 9 of the remaining 16 samples. In 7 samples, lymph nodes were absent. Conclusion: Our results suggest that the vein directly overlying the sternocleidomastoid muscle may not be the ideal candidate for a venous lymph-node flap.

Anatomical Variations of the External Jugular Vein: A Pictorial and Critical Review

“…Lymph nodes are mainly linked to the venous system, and it is often not clear whether there is an arterial supply at all [ 21 ]. As quoted in [ 21 ], Visconti et al (2017) proposed a novel concept pertaining to the venous lymph node flap—a vein with the surrounding lymph nodes could be transplanted to a major vein of a lymphedematous tissue [ 22 ]. Visconti’s experiments used venous lymph node flaps based on the EJV [ 22 ].…”