Four cases of spinal accessory nerve passing through the fenestrated internal jugular vein

Abstract

Although this anomaly is rare, head and neck surgeons should be aware of this anomalous relationship between the SAN and the IJV in order to avoid accidental injury to these structures during ND.

Fenestrated internal jugular vein: a rare finding in neck dissection

“…This finding has been reported previously in a very few cases with the spinal accessory nerve passing through the fenestration. [2][3][4] However, in this case no structures were observed to be associated with the fenestration.…”

“…Very few cases of duplication or fenestration of the IJV have been described. [2][3][4][5][6][7][8][9] Although these terms refer to two distinct patterns of IJV anomaly, they are often used similarly in the literature. Downie et al 10 classified IJV malformations into two patterns.…”

Penetration of cranial nerves by intracranial arteries and veins: a comprehensive review

“…[29] The passing of the accessory nerve through a fenestrated internal jugular vein was reported in 0.9%-2.8% of reported cases. [10,28,30] In all cases, the nerve always passed medially to the anterior part and laterally to the posterior part of the fenestrated IJV. Scholars proposed that the IJV duplication is likely to originate from an inadequate condensation of the embryonic capillary plexus, a structure developing posterior to the precardial veins.…”

“…Scholars proposed that the IJV duplication is likely to originate from an inadequate condensation of the embryonic capillary plexus, a structure developing posterior to the precardial veins. [28] Most of the abnormalities within IJV are unilateral. [3] There have been seven cases of the accessory nerve passing through the fenestration of internal jugular vein that have been reported.…”

“…[28] Among others, the internal jugular vein (IJV) and the accessory nerve are considered the most important structures in neck dissections, as they provide notable intraoperative landmarks, hence enhancing surgical precision and accuracy. [29] Accessory nerve injuries can lead to severe post-operative morbidities, including chronic shoulder pain and weakness.…”