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The Journal of Craniofacial SurgeryThe anterior jugular vein (AJV) is part of the superficial venous drainage system of the head and neck. Recently, interest in AJV is increasing as various surgical...
INTRODUCTION
The anterior jugular vein (AJV) is part of the superficial venous drainage system of the head and neck. Recently, interest in AJV is increasing as various surgical procedures have been developed. The authors conducted a cadaveric study to determine characteristics of AJV in Koreans.
METHODS
A total of 44 cadavers were dissected. Anatomical characteristics were analyzed for 34 cadavers in which AJV was well observed.
RESULTS
In this study, 21 were males and 13 were females. There were 8 cadavers with only 1 AJV from both sides. There was no significant difference in anatomical characteristics according to gender or AJV variation except for a difference in the length of the neck according to gender. However, it was possible to find a safety zone at the main landmark of the neck that could avoid AJV damage.
CONCLUSIONS
By using this safety zone, it is possible to prevent damage to the AJV and reduce complications during various surgical procedures on the head and neck.
Topics: Cadaver; Drainage; Female; Head; Humans; Jugular Veins; Male; Neck
PubMed: 35220348
DOI: 10.1097/SCS.0000000000008594 -
Nederlands Tijdschrift Voor Geneeskunde Nov 2023Accurately assessing volume status is crucial, as an incorrect evaluation can lead to inappropriate therapy. Evaluating volume status using medical history and physical...
Accurately assessing volume status is crucial, as an incorrect evaluation can lead to inappropriate therapy. Evaluating volume status using medical history and physical examination can be challenging. Medical history and physical examination are readily available, cost-effective, and non-invasive, remaining the initial steps in assessing fluid status. Point-of-care ultrasound (POCUS) is a valuable adjunct to physical examination. The collapse point of the internal jugular vein, the diameter of the inferior vena cava, and the presence of pulmonary B-lines can be easily and rapidly assessed using POCUS. Combining medical history, physical examination, and POCUS enhances diagnostic certainty in evaluating volume status.
Topics: Humans; Ultrasonography; Point-of-Care Testing; Vena Cava, Inferior; Physical Examination; Jugular Veins; Point-of-Care Systems
PubMed: 37994742
DOI: No ID Found -
Medicine Oct 2022This study aimed to detect the correlation of central venous pressure (CVP) with the internal jugular vein (IJV), common carotid artery (CCA), femoral vein (FV), and...
BACKGROUND
This study aimed to detect the correlation of central venous pressure (CVP) with the internal jugular vein (IJV), common carotid artery (CCA), femoral vein (FV), and femoral artery (FA) diameters measured with ultrasound (USG) in patients under mechanical ventilation to evaluate whether they are suitable to be used as an alternative low-cost and noninvasive method for the detection of CVP.
METHODS
A total of 40 patients aged from 18 to 90 who had been receiving therapy in the intensive care unit (ICU) were included in the study. Central venous catheter was placed into the patients through right IJV or subclavian vein in their first 24-hour of hospitalization and the right atrium pressure (RAP) was measured from the catheter, the tip of which was confirmed to reach right atrium. In the same session, CCA, IJV, FA, and FV diameters were measured with USG and their correlations with CVP were calculated. In addition, correlations of the measured venous and artery diameters between each other were detected as well.
RESULTS
There was a significantly high correlation between CVP and CCA diameter (R = 0.603, P < .000). There was a significantly low correlation between CVP and IJV diameter (R = 0.352, P = .026), a significantly low correlation between FA and FV diameters (R = 0.317, P = .047), a significantly low correlation between FA and CCA diameters (R = 0.330, P = .038), and a significantly low correlation between IJV and CCA diameters (R = 0.364, P = .020).
CONCLUSION
CVP and CCA diameters exhibited a high correlation. For detection of CVP, the ultrasonographic CCA diameter measurement can be used as an alternative noninvasive method which is easy to use and minimally affected by measurement errors of individuals and which has low learning curve compared with the other measurement methods.
Topics: Humans; Jugular Veins; Central Venous Pressure; Femoral Vein; Femoral Artery; Carotid Artery, Common; Ultrasonography; Catheterization, Central Venous
PubMed: 36316929
DOI: 10.1097/MD.0000000000031207 -
Surgical and Radiologic Anatomy : SRA Oct 2021Many anatomical variations of the superficial veins of the head and neck have been reported throughout the literature. Accordingly, anatomists and surgeons must have a... (Review)
Review
OBJECTIVE
Many anatomical variations of the superficial veins of the head and neck have been reported throughout the literature. Accordingly, anatomists and surgeons must have a comprehensive understanding of these variations to avoid confusion. Duplication of the external jugular vein (EJV) is occasionally observed during routine cadaveric dissections; however, this variation seems to be reported less often than actual experience suggests. Therefore, to gain a better understanding of its anatomical and clinical implications, an analysis of the available data should be available. Thus, in this article, we reviewed the current available literature for studies reporting duplication of the EJV.
METHODS
We conducted a search using PubMed and Google Scholar with the following keywords: "duplication of the external jugular vein," "division of the external jugular vein," and "fenestration of the external jugular vein," "double external jugular vein," and "doubled external jugular vein." As a case illustration, we also describe a case of a duplicated EJV found during a right neck dissection of a female cadaver.
RESULTS
Twenty sides across sixteen different studies were analyzed including the present case. All studies were published between 2009 and 2020. EJV division patterns were classified as either duplication, fenestration, fenestration followed by duplication, or double fenestrations.
CONCLUSIONS
We have reviewed the literature regarding cases documenting duplication/fenestration of the EJV. As it is often difficult to find recent studies that report on classic anatomical variations, therefore, revisiting older articles and textbooks is necessary for achieving a "comprehensive" review, especially across different languages.
Topics: Cadaver; Communication Barriers; Databases, Factual; Humans; Jugular Veins; Language
PubMed: 33620594
DOI: 10.1007/s00276-021-02717-6 -
Critical Care (London, England) Sep 2023Critical care patients often require central venous cannulation (CVC). We hypothesized that real-time biplane ultrasound-guided CVC would improve first-puncture success... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Critical care patients often require central venous cannulation (CVC). We hypothesized that real-time biplane ultrasound-guided CVC would improve first-puncture success rate and reduce mechanical complications. The purpose of this study was to compare the success rate and safety of single-plane and real-time biplane approaches for ultrasound-guided CVC.
METHODS
From October 2022 to March 2023, 256 participants with critical illness requiring CVC were randomized to either the single-plane (n = 128) or biplane (n = 128) ultrasound-guided cannulation groups. The success rate, number of punctures, procedure duration, incidence of catheterization-related complications, and confidence score of operators were documented.
RESULTS
The central vein was successfully cannulated in all 256 participants (163 [64%] man and 93 [36%] women; mean age 69 ± 19 [range 13-104 years]), including 182 and 74 who underwent internal jugular vein cannulation (IJVC) and femoral vein cannulation (FVC), respectively. The incidence of successful puncture on the first attempt was higher in the biplane group than that in the single-plane group (91.6% vs. 74.7%; relative risk (RR), 1.226; 95% confidence interval (CI), 1.069-1.405; P = 0.002 for the IJVC and 90.9% vs. 68.3%; RR, 1.331; 95% CI, 1.053-1.684; P = 0.019 for the FVC). The biplane group was also associated with a higher first-puncture single-pass catheterization success rate (87.4% vs. 69.0% and 90.9% vs. 68.3%), fewer undesired punctures (1[1-1(1-2)] vs. 1[1-2(1-4)] and 1[1-1(1-3)] vs. 1[1-2(1-4)]), shorter cannulation time (205 s [162-283 (66-1,526)] vs. 311 s [243-401 (136-1,223)] and 228 s [193-306 (66-1,669)] vs. 340 s [246-499 (130-944)]), and fewer immediate complications (10.5% vs. 28.7% and 9.1% vs. 34.1%) for both IJVC and FVC (all P < 0.05).
CONCLUSION
Real-time biplane imaging of ultrasound-guided CVCs offers advantages over the single-plane approach for critically ill patients.
TRIAL REGISTRATION
This prospective RCT was registered at Chinese Clinical Trial Registry (ChiCTR2200064843). Registered 19 October 2022.
Topics: Male; Humans; Female; Adolescent; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Catheterization, Central Venous; Ultrasonography, Interventional; Prospective Studies; Ultrasonography; Jugular Veins; Critical Illness; Critical Care
PubMed: 37742018
DOI: 10.1186/s13054-023-04635-y -
Medicina (Kaunas, Lithuania) Mar 2020There is a paucity of research on the shape of internal jugular vein (IJV) and their association with an individual's morphology and various chronic diseases.... (Comparative Study)
Comparative Study
There is a paucity of research on the shape of internal jugular vein (IJV) and their association with an individual's morphology and various chronic diseases. Therefore, this study aimed to analyze the anatomy of the IJV across various patients and to relate the differences in anatomy to basic patient characteristics. This retrospective study included a total of 313 patients who underwent contrast-enhanced neck computed tomography between January 2017 and December 2018. The circumferences of the right and left IJVs were measured at three locations (hyoid bone, cricoid cartilage, and first thoracic vertebra) and parameters affecting the size of the IJV were analyzed. The right IJV was significantly larger than the left IJV at each position ( < 0.001), and the area of the lumen was the largest at the cricoid cartilage level ( < 0.001). After dividing the right IJV data into two groups (above and below the median area), multivariate logistic regression analysis showed that age (odds ratio (OR) 1.040; 95% confidence interval (CI) 1.022-1.058, < 0.001) and body mass index (BMI, OR 1.080; 95% CI 1.011-1.154, = 0.0.23) affected size. The right IJV is larger than the left and has a rhomboid morphology. Age and BMI are significant factors affecting the IJV size.
Topics: Age Factors; Aged; Body Mass Index; Catheterization, Central Venous; Contrast Media; Female; Humans; Jugular Veins; Male; Neck; Observational Studies as Topic; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 32197519
DOI: 10.3390/medicina56030135 -
Journal of Alzheimer's Disease : JAD 2023It remains unclear whether changes in the venous circulation contribute to cognitive decline.
BACKGROUND
It remains unclear whether changes in the venous circulation contribute to cognitive decline.
OBJECTIVE
This study aimed to clarify whether the spontaneous jugular vein reflux (JVR) is associated with cognitive impairment and incident dementia.
METHODS
Patients with any evidence of cerebral vessel disease on magnetic resonance imaging (MRI) were consecutively enrolled between October 2015 to July 2019. We employed carotid duplex sonography to measure the internal jugular vein (IJV). The subjects were classified into two groups based on the degree of JVR on either side: none, mild (JVR(-) group) and moderate, severe (JVR (+) group) JVR. They underwent both the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment-Japanese (MoCA-J) global tests. Their cognitive status was prospectively assessed until March 2023.
RESULTS
302 patients with an MMSE score ≥24 underwent duplex sonography of the IJV. Among them, 91 had spontaneous JVR on either side. Both MMSE and MoCA-J were significantly lower in patients with JVR (+) group than in the JVR (-) group. After the adjustment for risk factors and MRI findings, intergroup differences in MoCA-J remained significant. Among the cognitive subdomains, median executive function and memory scores were significantly lower in the JVR (+) group than in the JVR (-) group. During the median 5.2-year follow-up, 11 patients with incident dementia were diagnosed. Patients with severe JVR were significantly more likely to be diagnosed with dementia (log-rank test, p = 0.031).
CONCLUSIONS
Spontaneous IJV reflux especially severe JVR, was associated with global cognitive function, and potentially with incident dementia.
Topics: Humans; Case-Control Studies; Jugular Veins; Cognitive Dysfunction; Magnetic Resonance Imaging; Dementia; Neuropsychological Tests
PubMed: 37927264
DOI: 10.3233/JAD-230771 -
CNS Neuroscience & Therapeutics Nov 2022Differentiating between acquired stenosis (pathologic) and anatomical slenderness (physiologic) of internal jugular vein (IJV) remain ambiguous. Herein, we aimed to...
BACKGROUND AND PURPOSES
Differentiating between acquired stenosis (pathologic) and anatomical slenderness (physiologic) of internal jugular vein (IJV) remain ambiguous. Herein, we aimed to compare the similarities and differences between the two entities.
METHODS
Patients who underwent head and neck computer tomography (CT) and brain magnetic resonance imaging (MRI) were enrolled in this case-control study from January 2016 through October 2021.
RESULTS
1487 eligible patients entered final analysis totally. 803 patients had bilateral IJVs imaging without IJV stenosis-related symptoms and presented in three ways: right IJV slenderness (10.5%, n = 85), left IJV slenderness (48.4%, n = 388), and symmetric IJVs (41.1%, n = 330). In patients with asymmetric IJVs, their bilateral jugular foramina were also asymmetric. All involved asymmetric IJVs presented as slenderness without surrounding abnormal collaterals and credible cloudy-like white matter hyper-intensity (WMH). Their cerebral arterial perfusion statuses on brain MR-PWI maps were normal. In contrast, the major patients with IJV stenosis presented with signs and symptoms such as headaches, head noise, etc. In CE-MRV maps, local stenosis of the IJV was surrounded by abnormal venous collaterals in contrast to the lack of abnormal venous collaterals for patients with IJV slenderness. And in CTV maps, the caliber of jugular foramina was mismatched with the transverse diameter of IJV. Moreover, in MRI maps of most of these patients, a cloudy-like WMHs were distributed symmetrically in bilateral periventricular and/or centrum semi vales. These patients also had symmetrical cerebral arterial hypo-perfusion. Seven patients underwent stenting of the IJV stenosis correction, their WMHs attenuated or disappeared subsequently.
CONCLUSIONS
Imaging features in addition to clinical symptoms can be used to differentiate between physiologic IJV slenderness and pathologic IJV stenosis. Notable imagine-defining features for IJV stenosis include local stenosis surrounded by abnormal venous collaterals, cloudy-like WMHs, and mismatch between the transverse diameter of IJV and the caliber of the jugular foramina.
Topics: Case-Control Studies; Constriction, Pathologic; Humans; Jugular Veins; Magnetic Resonance Imaging; Neck
PubMed: 35919952
DOI: 10.1111/cns.13924 -
Brazilian Journal of Otorhinolaryngology 2021Sigmoid sinus diverticulum has been considered the most common cause of pulsatile tinnitus; the mechanism underlying sigmoid sinus diverticulum formation is unclear. To...
INTRODUCTION
Sigmoid sinus diverticulum has been considered the most common cause of pulsatile tinnitus; the mechanism underlying sigmoid sinus diverticulum formation is unclear. To the best of our knowledge, no previous studies have assessed whether the formation of sigmoid sinus diverticulum is related to compression of the internal jugular vein by the styloid process.
OBJECTIVE
To discuss the relationship between the styloid process and the formation of sigmoid sinus diverticulum.
METHODS
The medical records of nine patients diagnosed with venous pulsatile tinnitus caused by sigmoid sinus diverticulum were reviewed between April 2009 and May 2019. All patients underwent high-resolution computed tomography of the temporal bones, computed tomography venogram of the head and neck, magnetic resonance venography, and brain magnetic resonance imaging. The length and medial angulation of the styloid process were measured, and compression of the internal jugular vein was recorded.
RESULTS
The study population consisted of nine female right-sided pulsatile tinnitus patients with a mean age of 53.8±4.6 years. The mean lengths of the styloid process were 3.9±0.6cm on the right side and 4.1±0.7cm on the left side. The mean medial angulation of the styloid process was significantly smaller on the right side than the left side (65.3°±1.2° vs. 67.8°±1.7°, p<0.05). In addition, computed tomography venogram of the head and neck demonstrated the left internal jugular vein was compressed by the styloid process in eight of the nine patients.
CONCLUSION
The formation of sigmoid sinus diverticulum with venous pulsatile tinnitus may be related to compression of the contralateral internal jugular vein by the styloid process. However, accumulation of data in additional cases is required to verify this suggestion.
Topics: Cranial Sinuses; Diverticulum; Female; Humans; Jugular Veins; Middle Aged; Tinnitus; Tomography, X-Ray Computed
PubMed: 32044273
DOI: 10.1016/j.bjorl.2019.12.006 -
The Journal of Vascular Access May 2021Pre-procedural evaluation of central veins prior to cannulation with ultrasound is essential to reduce the complication rates as well as to increase the success rates....
Pre-procedural evaluation of central veins prior to cannulation with ultrasound is essential to reduce the complication rates as well as to increase the success rates. The left brachiocephalic vein has been suggested to be considered as first choice in infants including the neonates due to its larger diameter and ease of access with supraclavicular, ultrasound-guided, in-plane technique. There are few studies on neonates and infants comparing the diameter of brachiocephalic vein with internal jugular vein being its most common alternative. The aim of the present report is to share our observations pertaining to the pre-procedural measurements of the diameters of left internal jugular vein and brachiocephalic vein in infants <1 year. The measurements were analysed in accordance with the weights of the infants (<2500 g and ⩾2500 g). In infants <2500 g, the brachiocephalic vein was larger than the internal jugular vein (4.0 ± 0.7 (3.2-5.2) mm vs 3.2 ± 0.7 (1.9- 4.3) mm, p = 0.032), whereas the diameters of two major veins were similar in infants ⩾2500 g (4.8 ± 1.2 (2.3-6.4) mm vs 5.1 ± 0.9 (2.8-6.7) mm, p = 0.363). Our observations support the suggestion of the brachiocephalic vein to be considered as the first choice for large-bore cannulation due to its larger diameter as well as its other advantages, especially in neonates <2500 g.
Topics: Age Factors; Birth Weight; Brachiocephalic Veins; Catheterization, Central Venous; Catheters, Indwelling; Central Venous Catheters; Clinical Decision-Making; Equipment Design; Humans; Infant; Infant, Low Birth Weight; Infant, Newborn; Jugular Veins; Predictive Value of Tests; Punctures; Ultrasonography, Doppler
PubMed: 32466713
DOI: 10.1177/1129729820925692