Abstract
Purpose
Neck dissection (ND) is an important technique for the treatment of cervical lymph node metastasis in patients with head and neck cancer. Since the introduction of functional ND (FND), various modifications have been made to reduce the adverse effects of radical ND. Recently, many investigators have documented cases of FND with preservation of the spinal accessory nerve (SAN) and/or the sternocleidomastoid muscle, which have contributed to improve the quality of life following ND. For this type of ND, special attention must be paid to identify the SAN and the internal jugular vein (IJV).
Methods
We performed 123 NDs over 2 years at the Department of Otolaryngology, Head and Neck Surgery, Kobe University Hospital. We collected data of all patients who underwent NDs by retrospectively reviewing the relevant hospital medical records and operative notes.
Results
In 4 out of 123 NDs (3.3%), an anomaly of the SAN passing through the fenestrated IJV was observed.
Conclusion
Although this anomaly is rare, head and neck surgeons should be aware of this anomalous relationship between the SAN and the IJV in order to avoid accidental injury to these structures during ND.
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References
Crile G (1906) Excision of cancer of the head and neck. JAMA 47:1780–1786
Downie SA, Schalop L, Mazurek JN et al (2007) Bilateral duplicated internal jugular veins. Clin Anat 20:260–266
Hollinshead WH (1985) Anatomy for surgeons: the head and neck. Hoeber-Harper, New York, pp 497–498
Inoue H, Nibu K, Saito M et al (2006) Quality of life after neck dissection. Arch Otolaryngol 132:662–666
Lee SH, Lee JK, Jin SM et al (2009) Anatomical variations of the spinal accessory nerve and its relevance to level IIb lymph nodes. Otolaryngol Head Neck 141:639–644
Ozturk NC, Talas DU (2010) Fenestration of internal jugular vein and relation to spinal accessory nerve. Clin Anat 23:883–884
Prades JM, Timoshenko A, Dumollard JM et al (2002) High duplication of the internal jugular vein: clinical incidence in the adult and surgical consequences, a report of three clinical cases. Surg Radiol Anat 24:129–132
Saman M, Etebari P, Pakdaman MN (2011) Anatomic relationship between the spinal accessory nerve and the jugular vein: a cadaveric study. Surg Radiol Anat 33:175–179
Suarez O (1963) El problema de las metastasis linfaticas y alejadas del cancer de laringe e hipofaringe. Rev Otorrinolaryngol Santiago 23:83–99
Towbin AJ, Kanal E (2004) A review of two cases of fenestrated internal jugular veins as seen by CT angiography. AJNR 25:1433–1434
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Hashimoto, Y., Otsuki, N., Morimoto, K. et al. Four cases of spinal accessory nerve passing through the fenestrated internal jugular vein. Surg Radiol Anat 34, 373–375 (2012). https://doi.org/10.1007/s00276-011-0875-x
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DOI: https://doi.org/10.1007/s00276-011-0875-x