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Surgical approach to internal and external jugular venous agenesis: case report

  • Anatomic Variations
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Abstract

Purpose

During reconstructive planning for mandibular resection and reconstruction, it was noted that the left internal and external jugular veins were absent, with a considerable compensatory internal jugular vein present on the contralateral side.

Methods

An accidental finding in the CT angiogram of the head and neck was assessed.

Results

Osteocutaneous fibular free flap is a well-established reconstructive surgery for mandibular defects that can involve anastomosis of the internal jugular vein and its tributaries. A 60-years-old man with intraoral squamous cell carcinoma, initially treated with chemoradiation, developed osteoradionecrosis of his left mandible. The patient then underwent resection of this portion of the mandible with reconstruction by osteocutaneous fibular free flap with virtual surgical planning. During reconstructive planning for the resection and reconstruction, it was noted that the left internal and external jugular veins were absent, and a noteworthy compensatory internal jugular vein was present on the contralateral side. We report a rare case of this combination of anatomical variations within the jugular venous system.

Conclusion

Unilateral agenesis of the internal jugular vein has been reported, but a combined variation with ipsilateral agenesis of the external jugular vein and compensatory enlargement of the contralateral internal jugular vein has, to our knowledge, not been reported on previously. The anatomical variation reported in our study will be useful during dissection, central venous catheter placement, styloidectomy, angioplasty/stenting, surgical excision, and reconstructive surgery.

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Funding

The authors declare that no funds, grants, or other financial support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Albany Medical College, Albany, NY, USA

    Sruti Bandlamuri

  2. Division of Anatomy, Albany Medical College, Albany, NY, USA

    Amanda S. Khan

  3. Division of Plastic and Reconstructive Surgery, Albany Medical Center, Albany, NY, USA

    Christie Bialowas

Authors
  1. Sruti Bandlamuri
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  2. Amanda S. Khan
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  3. Christie Bialowas
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Contributions

SB contributed to project development, data collection, data analysis, manuscript writing, and manuscript editing. AK contributed to data collection, data analysis, and manuscript editing. CB contributed to project development, data collection, data analysis, and manuscript editing.

Corresponding author

Correspondence to Sruti Bandlamuri.

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The authors have no competing interests, financial or personal, to declare.

Ethical approval

This is a case report of a single patient. The Albany Medical College Office of Research Affairs has confirmed that no IRB approval is required.

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Written informed consent was obtained from the patient to participate in this case report.

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Written informed consent was obtained from the patient to publish this case report.

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Bandlamuri, S., Khan, A.S. & Bialowas, C. Surgical approach to internal and external jugular venous agenesis: case report. Surg Radiol Anat 45, 989–993 (2023). https://doi.org/10.1007/s00276-023-03179-8

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  • DOI: https://doi.org/10.1007/s00276-023-03179-8

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