The omohyoid and sternocleidomastoid muscles entrapment of the internal jugular vein: Which role in Mèniére disease patients? Treatment perspective description

Abstract

The objectives were to analyze the Internal Jugular vein entrapment caused by muscles compression and the possible role and correlation in Mèniére disease. We describe the eco-color Doppler evaluation of a sternocleidomastoid and omohyoid muscles compression of internal jugular vein in a Mèniére patient, responsible of an anomalous venous cerebral and ear outflow. The proposed treatment was a three months muscolar decontractration physiotherapy program. The physiotherapy session allowed a complete muscles relaxation with an improvement of Internal Jugular vein caliber associated to a normalized cerebral and inner ear venous outflow and a progressive attenuation of Mèniére symptoms during the treatment and its disappearance at the end of the physiotherapy program. The comfort of the patient was confirmed during one-year follow-up. Muscles entrapment of Internal Jugular veins may be correlated with an anomalous cerebral and inner ear venous outflow, promoting the Mèniére disease symptoms. Physiotherapy treatment may represent an intriguing option alternatively of muscle surgical. The present case seems to indicate a possible first line treatment by physiotherapy, reserving surgical resection to not responders. Further studies with a wider sample of patients are warranted.

Multiple sclerosis and venous angioplasty for chronic cerebrospinal venous insufficiency: a case control study with ten years follow-up with patients at their own control

“…Muscular extrinsic secondary compression should be avoided as most possible and postural correction carefully detected or improved. 37 Quality of life is not just a question of mobility, but also dependency for more rehab and occupational therapy that altogether mean costs, both individual and to the healthcare system. Ten years of followup, for a consistent number of patients, regarding CCSVI vein abnormalities and disabilities, have bridged a series of gaps inside a progressive neurologic disease.…”

“…This phase served to determine eventual extrinsic muscle compression on the internal jugular vein, generally being the omohyoid muscle involved. 34,35,37,40 The reason for this manoeuvre was to reproduce the frequent "forwards slanting" position when using a walking-aid device. In our controlled series and accordingly with the results obtained by Zamboni et al, 31 the angioplasty procedures resulted being safe for the patient.…”