Letters to the Editor / British Journal of Oral and Maxillofacial Surgery 52 (2014) 771–773
Ishpinder Bachoo a Barrie Evans b,∗ a SHO in Oral and Maxillofacial Surgery, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD b Consultant Oral and Maxillofacial Surgeon, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD ∗ Corresponding author. Department of Oral and Maxillofacial Surgery, Mailpoint 58, C-level, Centre Block, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD. Tel.: +07931527628. E-mail addresses: ish [email protected] (I. Bachoo), [email protected] (B. Evans) 27 May 2014 Available online 26 July 2014 http://dx.doi.org/10.1016/j.bjoms.2014.05.016
Clinical importance of duplicated internal jugular vein We read with interest the recent paper by Bachoo and Evans.1 Duplication of the internal jugular vein is quite common, there being more than 18 case reports currently listed in PubMed. The authors are correct, however, when they say that duplication of the internal jugular vein in the lower part of the neck is not common. Perhaps that makes the anatomical variant more important for neck surgeons. It would be interesting to note if any obstruction results from this. A detailed computed tomographic scan would show any involvement of the vessel wall, which would help. Involvement of the smooth muscle, elastic fibres, and fibrofatty deposits suggest that the anomaly may be congenital.2 Interestingly, a past study has highlighted this. The anatomical landmark technique for the internal jugular vein in uraemic patients being given haemodialysis may be successful only in a quarter of cases, and sonographic evaluation should be routine.3 Duplication of the internal jugular vein may present as a swelling in the neck that resembles a branchial cyst or laryngocoele,4 and this should be taken into account
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during physical examination. Symptoms such as dysphagia and dyspnoea have also been reported.4 This is an interesting article for neck surgeons, and we congratulate the authors.
Conflict of Interest The authors have no conflict of interest.
Reference 1. Bachoo I, Evans B. Duplication of the lower third of the internal jugular vein - case report and surgical implications. Br J Oral Maxillofac Surg 2014;52:461–3. 2. Sugiyama S, Murakami A, Yokokawa M, Misaki T, Wakaki K. Internal jugular vein malformation with mature adipose deposits in the mediastinum. Surg Today Jpn J Surg 1998;28:455–8. 3. Lin BS, Kong CW, Tarng DC, Huang TP, Tang GJ. Anatomical variation of the internal jugular vein and its impact on temporary haemodialysis vascular access: an ultrasonographic survey in uraemic patients. Nephrol Dial Transplant 1998;13:134–8. 4. Wong BY, Strachan DR, Loney EL. Duplication of internal jugular veins: case report. J Laryngol Otol 2010;124:341–4.
Srijit Das a,∗ Chee Kong Christopher Ho b Ho Siew Eng c a Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia b Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre c Department of Nursing, Universiti Kebangsaan Malaysia Medical Centre ∗ Corresponding author. Professor, Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abd Aziz, 50300, Kuala Lumpur, Malaysia. Tel.: +006-03-92897263; fax: +006-03-26989506. E-mail address: [email protected] (S. Das) 24 May 2014 Available online 16 Jun 2014 http://dx.doi.org/10.1016/j.bjoms.2014.05.015
Ishpinder Bachoo a Barrie Evans b,∗ a SHO in Oral and Maxillofacial Surgery, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD b Consultant Oral and Maxillofacial Surgeon, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD ∗ Corresponding author. Department of Oral and Maxillofacial Surgery, Mailpoint 58, C-level, Centre Block, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD. Tel.: +07931527628. E-mail addresses: ish [email protected] (I. Bachoo), [email protected] (B. Evans) 27 May 2014 Available online 26 July 2014 http://dx.doi.org/10.1016/j.bjoms.2014.05.016
Clinical importance of duplicated internal jugular vein We read with interest the recent paper by Bachoo and Evans.1 Duplication of the internal jugular vein is quite common, there being more than 18 case reports currently listed in PubMed. The authors are correct, however, when they say that duplication of the internal jugular vein in the lower part of the neck is not common. Perhaps that makes the anatomical variant more important for neck surgeons. It would be interesting to note if any obstruction results from this. A detailed computed tomographic scan would show any involvement of the vessel wall, which would help. Involvement of the smooth muscle, elastic fibres, and fibrofatty deposits suggest that the anomaly may be congenital.2 Interestingly, a past study has highlighted this. The anatomical landmark technique for the internal jugular vein in uraemic patients being given haemodialysis may be successful only in a quarter of cases, and sonographic evaluation should be routine.3 Duplication of the internal jugular vein may present as a swelling in the neck that resembles a branchial cyst or laryngocoele,4 and this should be taken into account
773
during physical examination. Symptoms such as dysphagia and dyspnoea have also been reported.4 This is an interesting article for neck surgeons, and we congratulate the authors.
Conflict of Interest The authors have no conflict of interest.
Reference 1. Bachoo I, Evans B. Duplication of the lower third of the internal jugular vein - case report and surgical implications. Br J Oral Maxillofac Surg 2014;52:461–3. 2. Sugiyama S, Murakami A, Yokokawa M, Misaki T, Wakaki K. Internal jugular vein malformation with mature adipose deposits in the mediastinum. Surg Today Jpn J Surg 1998;28:455–8. 3. Lin BS, Kong CW, Tarng DC, Huang TP, Tang GJ. Anatomical variation of the internal jugular vein and its impact on temporary haemodialysis vascular access: an ultrasonographic survey in uraemic patients. Nephrol Dial Transplant 1998;13:134–8. 4. Wong BY, Strachan DR, Loney EL. Duplication of internal jugular veins: case report. J Laryngol Otol 2010;124:341–4.
Srijit Das a,∗ Chee Kong Christopher Ho b Ho Siew Eng c a Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia b Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre c Department of Nursing, Universiti Kebangsaan Malaysia Medical Centre ∗ Corresponding author. Professor, Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abd Aziz, 50300, Kuala Lumpur, Malaysia. Tel.: +006-03-92897263; fax: +006-03-26989506. E-mail address: [email protected] (S. Das) 24 May 2014 Available online 16 Jun 2014 http://dx.doi.org/10.1016/j.bjoms.2014.05.015
