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World Journal of Surgical Oncology Jan 2023Donor-recipient diameter discrepancy can be problematic when using an autologous great saphenous vein graft for internal jugular vein reconstruction. A triple-paneled...
BACKGROUND
Donor-recipient diameter discrepancy can be problematic when using an autologous great saphenous vein graft for internal jugular vein reconstruction. A triple-paneled method of saphenous vein grafting is one solution.
CASE PRESENTATION
A 54-year-old man with a thyroid papillary carcinoma underwent total thyroidectomy and bilateral neck dissection. An 8-cm segment of the right internal jugular vein was resected. For reconstruction, a 30-cm segment of the great saphenous vein was harvested and divided into three pieces of equal length. After opening each piece longitudinally, they were sutured together in a side-by-side fashion to create a cylinder that was used to reconstruct the internal jugular vein defect. The graft was patent 10 months after the surgery.
CONCLUSION
The triple-paneled method is feasible for autologous great saphenous vein graft reconstruction of the internal jugular vein.
Topics: Male; Humans; Middle Aged; Jugular Veins; Saphenous Vein; Neck Dissection; Thyroidectomy; Transplants
PubMed: 36647096
DOI: 10.1186/s12957-023-02902-4 -
Current Oncology (Toronto, Ont.) Nov 2022Internal jugular vein tumor thrombus is an extremely rare condition in thyroid carcinoma, but it does exist. Correlated with greater aggressiveness with a higher...
Internal jugular vein tumor thrombus is an extremely rare condition in thyroid carcinoma, but it does exist. Correlated with greater aggressiveness with a higher incidence of distant metastases at diagnosis and a higher recurrence rate, this important prognostic element should be systematically investigated by ultrasound operators in all patients presenting with thyroid carcinoma. The patient's follow-up must be careful. This can be a trap that surgeons must look for in their preoperative checklist. We report the case of a 58-year-old woman with an IJV thrombus associated with multiple bone metastases. She underwent successful surgical treatment, and postoperative pathology showed a poorly differentiated follicular carcinoma of the thyroid and a tumor thrombus in the internal jugular vein.
Topics: Female; Humans; Middle Aged; Jugular Veins; Thrombosis; Thyroid Neoplasms; Surgeons
PubMed: 36547137
DOI: 10.3390/curroncol29120723 -
Physiological Reports Apr 2021Internal jugular flow is reduced in space compared with supine values, which can be associated with internal jugular vein (IJV) thrombosis. The mechanism is unknown but...
Internal jugular flow is reduced in space compared with supine values, which can be associated with internal jugular vein (IJV) thrombosis. The mechanism is unknown but important to understand to prevent potentially serious vein thromboses on long duration flights. We used a novel, microgravity-focused numerical model of the cranial vascular circulation to develop hypotheses for the reduced flow. This model includes the effects of removing hydrostatic gradients and tissue compressive forces - unique effects of weightlessness. The IJV in the model incorporates sensitivity to transmural pressure across the vein, which can dramatically affect resistance and flow in the vein. The model predicts reduced IJV flow in space. Although tissue weight in the neck is reduced in weightlessness, increasing transmural pressure, this is more than offset by the reduction in venous pressure produced by the loss of hydrostatic gradients and tissue pressures throughout the body. This results in a negative transmural pressure and increased IJV resistance. Unlike the IJV, the walls of the vertebral plexus are rigid; transmural pressure does not affect its resistance and so its flow increases in microgravity. This overall result is supported by spaceflight measurements, showing reduced IJV area inflight compared with supine values preflight. Significantly, this hypothesis suggests that interventions that further decrease internal IJV pressure (such as lower body negative pressure), which are not assisted by other drainage mechanisms (e.g. gravity), might lead to stagnant flow or IJV collapse with reduced flow, which could increase rather than decrease the risk of venous thrombosis.
Topics: Computer Simulation; Humans; Jugular Veins; Regional Blood Flow; Supine Position; Weightlessness
PubMed: 33931957
DOI: 10.14814/phy2.14782 -
Brazilian Journal of Otorhinolaryngology 2020The anatomical complexity of the jugular foramen makes surgical procedures in this region delicate and difficult. Due to the advances in surgical techniques, approaches...
INTRODUCTION
The anatomical complexity of the jugular foramen makes surgical procedures in this region delicate and difficult. Due to the advances in surgical techniques, approaches to the jugular foramen became more frequent, requiring improvement of the knowledge of this region anatomy.
OBJECTIVE
To study the anatomy of the jugular foramen, internal jugular vein and glossopharyngeal, vagus and accessory nerves, and to identify the anatomical relationships among these structures in the jugular foramen region and lateral-pharyngeal space.
METHODS
A total of 60 sides of 30 non-embalmed cadavers were examined few hours after death. The diameters of the jugular foramen and its anatomical relationships were analyzed.
RESULTS
The diameters of the jugular foramen and internal jugular vein were greater on the right side in most studied specimens. The inferior petrosal sinus ended in the internal jugular vein up to 40mm below the jugular foramen; in 5% of cases. The glossopharyngeal nerve exhibited an intimate anatomical relationship with the styloglossus muscle after exiting the skull, and the vagal nerve had a similar relationship with the hypoglossal nerve. The accessory nerve passed around the internal jugular vein via its anterior wall in 71.7% of cadavers.
CONCLUSION
Anatomical variations were found in the dimensions of the jugular foramen and the internal jugular vein, which were larger in size on the right side of most studied bodies; variations also occurred in the trajectory and anatomical relationships of the nerves. The petrosal sinus can join the internal jugular vein below the foramen.
Topics: Accessory Nerve; Adult; Aged; Aged, 80 and over; Anatomic Variation; Dissection; Female; Glossopharyngeal Nerve; Humans; Jugular Foramina; Jugular Veins; Male; Middle Aged; Neck; Vagus Nerve
PubMed: 30348503
DOI: 10.1016/j.bjorl.2018.09.004 -
Revista Brasileira de Terapia Intensiva 2015
Topics: Female; Fluid Therapy; Humans; Jugular Veins; Male; Respiration, Artificial; Vena Cava, Inferior
PubMed: 26465240
DOI: 10.5935/0103-507X.20150039 -
Ultrasound in Medicine & Biology Aug 2018A consensus on venous flow quantification using echo spectral Doppler sonography is lacking. Doppler sonography data from 83 healthy individuals were examined using...
A consensus on venous flow quantification using echo spectral Doppler sonography is lacking. Doppler sonography data from 83 healthy individuals were examined using manually traced transverse cross-sectional area and diameter-derived cross-sectional area obtained in longitudinal view measurements of the internal jugular vein. Time-averaged velocity over a 4-s interval was obtained in the longitudinal plane using manual tracing of the waveform. Manual and computer-generated blood flow volume calculations were also obtained for the common carotid artery, for accuracy purposes. No differences were detected between semi-automated and manual blood flow volume calculations for the common carotid artery. The manual calculation method resulted in almost twofold larger venous internal jugular vein flow measurements compared with the semi-automated method. Doppler sonography equipment does not provide accurate automated calculation of venous size and blood flow. Until further technological development occurs, manual calculation of venous blood flow is warranted.
Topics: Adult; Blood Flow Velocity; Female; Humans; Jugular Veins; Male; Prospective Studies; Reference Values; Reproducibility of Results; Ultrasonography, Doppler
PubMed: 29784437
DOI: 10.1016/j.ultrasmedbio.2018.04.010 -
The Journal of International Medical... Aug 2019Although internal jugular vein stenosis (IJVS) is not uncommon, a lack of clinical attention will lead to misdiagnosis and missed diagnosis. This study describes two... (Review)
Review
Although internal jugular vein stenosis (IJVS) is not uncommon, a lack of clinical attention will lead to misdiagnosis and missed diagnosis. This study describes two 61-year-old women with bilateral IJVS induced by tortuous internal carotid artery compression and reviews current reports on this condition, including its clinical characteristics and treatment strategies, to provide a reference for clinicians.
Topics: Carotid Artery, Internal; Carotid Stenosis; Constriction, Pathologic; Female; Humans; Jugular Veins; Middle Aged
PubMed: 31304848
DOI: 10.1177/0300060519860678 -
Physiological Reports May 2022Head-up tilt (HUT)-induced gravitational stress causes collapse of the internal jugular vein (IJV) by decreasing central blood volume and through mass-effect from the...
Head-up tilt (HUT)-induced gravitational stress causes collapse of the internal jugular vein (IJV) by decreasing central blood volume and through mass-effect from the surrounding tissues. Besides HUT, lower body negative pressure (LBNP) is used to stimulate orthostatic stress as an experimental model. Compared to HUT, LBNP has less of a gravitational effect because of the supine position; therefore, we hypothesized that LBNP causes less of a decrease in the cross-sectional area of the IJV compared to HUT. We tested the hypothesis by measuring the cross-sectional area of the IJV using B-mode ultrasonography while inducing orthostatic stress at levels of -40 mmHg LBNP and 60° HUT. The cross-sectional area of IJV decreased from the resting baseline during both LBNP and HUT trials, but the LBNP-induced decrease in the cross-sectional area of IJV was smaller than that of HUT (right, -45% ± 49% vs. -78% ± 27%, p = 0.008; left, -49% ± 27% vs. -78% ± 20%, p = 0.004). Since changes in venous outflow may affect cerebral arterial circulation, the findings of the present study suggest that orthostatic stress induced by different techniques modulates cerebral blood flow regulation through its effect on venous outflow.
Topics: Blood Pressure; Cerebrovascular Circulation; Jugular Veins; Lower Body Negative Pressure; Posture
PubMed: 35581747
DOI: 10.14814/phy2.15248 -
Deutsches Arzteblatt International Jul 2022
Topics: Humans; Accessory Nerve; Jugular Veins; Neck
PubMed: 36342094
DOI: 10.3238/arztebl.m2022.0097 -
Annals of Cardiac Anaesthesia 2021Central venous access is useful for monitoring central venous pressure, inserting pulmonary artery catheter and administering vasoactive drugs in hemodynamically...
Central venous access is useful for monitoring central venous pressure, inserting pulmonary artery catheter and administering vasoactive drugs in hemodynamically unstable patients. Central venous catheter (CVC) insertion through internal jugular vein may cause major vessel injury, inadvertent arterial catheterization, brachial plexus injury, phrenic nerve injury, pneumothorax, and haemothorax. We describe unusual presentation of hemothorax following CVC placement in a patient undergoing vestibular schwannoma excision. The patients' trachea intubated after several attempts during which thiopentone up to 600 mg administered. Thereafter, under ultrasound guidance, an 18G introducer needle placed in the right internal jugular vein but guide-wire did not advance. Meanwhile, the patient became hemodynamically unstable and a CVC placed in right subclavian vein and norepinephrine infused at 0.05 μg/kg/min; simultaneously, 1000 ml normal saline administered through CVC. The hemodynamic instability attributed to thiopentone administered during endotracheal intubation. The surgical procedure cancelled, and the patient shifted to critical care unit (CCU). Mechanical ventilation continued. In CCU, hemodynamic parameters further deteriorated and 0.1 μg/kg/min epinephrine started. Bedside lung ultrasound showed a large collection in pleural space on the right side. Chest radiograph showed a homogenous opacity obliterating costophrenic angle on the right side. A possibility of hemothorax considered, chest tube inserted and 1000 ml sanguineous fluid drained. Blood sample drawn through CVC showed air from proximal and middle lumen but distal lumen drained blood. Another CVC placed in the femoral vein and subclavian vein CVC removed. The vasoactive drug infusion transferred to CVC in femoral vein and 2 units pRBCs transfused. Hemodynamic parameters gradually stabilized and the patient recovered completely.
Topics: Catheterization, Central Venous; Central Venous Catheters; Humans; Jugular Veins; Medical Futility; Subclavian Vein
PubMed: 34269274
DOI: 10.4103/aca.ACA_112_20