The position of the common facial vein in neonates: An alternate route for central venous catheter placement.

Abstract

We determine the location of the common facial vein (CFV) in a sample of neonates and assess the safety of this vein as an alternative access route for a central venous catheter (CVC). We dissected both the left and right sides of the neck region in 24 neonatal, formalin-fixed cadavers, exposing the underlying soft tissues and neurovascular structures. We identified the CFV, which we then pinned together with the internal jugular vein, cervical branch of facial nerve, marginal mandibular branch of the facial nerve, the cricoid cartilage, brachiocephalic vein, and the mastoid and sternal attachments of the sternocleidomastoid muscle. We measured the CFV and the related pinned structures. In neonates, the CFV intersected the anterior border of sternocleidomastoid on average 19.53 mm (left) and 21.73 mm (right) from its sternal attachment. We found the CFV inferior to the upper one third and just superior to half of the length of the sternocleidomastoid muscle, indicating a possible "safe-zone" where a skin incision could be made over the anteromedial border of sternocleidomastoid. The CFV is easily identified from surrounding landmarks. It could be used as a safe, alternative route for inserting a CVC if its average length (8.72 mm) and diameter (1.50 mm) are taken into account.