Abstract
Background: Comprehensive knowledge of the internal jugular vein (IJV) regarding its anatomical variations and the pattern of its course is valuable for preventing unexpected injuries during surgical procedures or central venous access. IJV anatomical anomalies such as fenestration and duplication are rare, mainly represented by case reports, and intraoperative findings.Objective: To present two additional cases of IJV anomalies and highlight its clinical presentation, anatomical characteristics, management, and prevalence through an extensive literature review.Methods and Case Reports: From January 2017 to December 2018, we retrospectively collected data of 221 patients undergoing neck dissection (ND) procedures and identified two patients with IJV anomalies (fenestration and duplication) providing a clinical prevalence of ~0.9%. The IJV fenestration referred to an IJV bifurcation that reunites proximal to the subclavian vein, whereas in the IJV duplication both branches remain separated. In both of our cases, the spinal accessory nerve (SAN) crossed the window between the IJV branches.Conclusion: Anatomical variations are more likely to be identified intraoperatively or incidentally, and due to the risk of SAN and vascular injury, special attention should be taken to identify them preoperatively in order to reduce the risk of iatrogenic injury and unexpected complications.
Highlights
Neck dissection (ND) or cervical lymphadenectomy is a frequent procedure performed in the management of patients with head and neck cancer [1]
ND depends on recognizing patient-specific anatomic structures that may increase their risk of an adverse outcome
The internal jugular vein (IJV) can present certain anomalies such as: duplication or either fenestration [6, 7]
Summary
Neck dissection (ND) or cervical lymphadenectomy is a frequent procedure performed in the management of patients with head and neck cancer [1]. The IJV can present certain anomalies such as: duplication (referring to a bifurcation of the vein with each branch having a separate connection to the subclavian vein) or either fenestration (which refers to a bifurcation that reunites proximal to the subclavian vein) [6, 7]. Identifying these anatomical variations is useful to avoid unexpected surgical complications or during central venous catheterization. IJV anatomical anomalies such as fenestration and duplication are rare, mainly represented by case reports, and intraoperative findings
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
