Unilateral external jugular vein fenestration with variant anatomy of the retromandibular and facial vein

Abstract

External jugular vein (EJV), a significant superficial vein draining head and neck (H&N) region is been increasingly used for cannulation in diverse diagnostic purposes and intravenous therapies. The variant anatomy of formation and draining patterns of EJV and retromandibular veins were reported earlier. In the present case, EJV showed significant variation in one of the male cadaver, during routine H&N dissection. On the left side, a fenestration of EJV was observed and the transverse cutaneous nerve of the neck was passing through the fenestration of the vein. Anatomical knowledge of EJV and retromandibular vein variations as found in this case is important for surgeons performing microvascular surgeries in H&N and also to the radiologists during their conventional radiological procedures like angioplasty, catheterization, and at times of hemodialysis in case of renal failure patients.

Variation in the formation of the retromandibular and the external jugular veins with embryological overview: A case report

“…At times, there would be a communicating venous channel between EJV and the IJV. The jugular veins could be duplicated or fenestrated in their course in the neck region [ 5 , 6 , 15 , 16 ]. However, the fenestrated vein is the one, which has a single trunk at its formation and termination but split in its course.…”

“…The literature reveals several types of variations of RMV and EJV [ [5] , [6] , [7] , [8] ]. Variations are often seen in the formation and course of EJV and RMV that is described the literature [ 9 ].…”

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

“…According to Ponnambalam and Karuppiah, fenestrations of the EJV could result after both divisions of the RMV descend and reunite on the SCM [ 51 ], such as we present in Figure 17 . However, we present in Figure 18 an RMV with both anterior and posterior divisions and with a fenestration of its main trunk and posterior division, further receiving the posterior auricular vein and continued as EJV.…”

“…Numerous cases of fenestration of the EJV have been published [ 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. No specific length of the EJV until its fenestration was observed as it may occur at any anatomical spot, along the course of the vein.…”

Terminal bifurcation of the external jugular vein: a rare variation

“…External jugular vein is used to assess the right atrial pressure as this vein does not possess any valves. The vein may be entirely absent unilaterally or bilaterally [1], duplicated [2], or fenestrated [3]. Apart from this, many variations in its origin, course and termination have been reported.…”