Anat Cell Biol.  2014 Jun;47(2):135-137. 10.5115/acb.2014.47.2.135.

Absence of retromandibular vein associated with atypical formation of external jugular vein in the parotid region

• Patil J
• Kumar N
• Swamy RS
• D'Souza MR
• Guru A
• Nayak SB

• KMID: 1882585
• DOI: http://doi.org/10.5115/acb.2014.47.2.135

Abstract

Veins of the head and neck exhibiting anatomical variations or malformations are clinically significant. Anatomical variation in the external jugular vein is very common. However, anatomical variation in the retromandibular vein is rare. In this paper, we report a rare case of complete absence of the retromandibular vein. In the absence of the retromandibular vein, the maxillary vein divided into anterior and posterior divisions. The posterior division joined the superficial temporal vein to form an atypical external jugular vein, and the anterior division joined the facial vein to form an anonymous vein. In clinical practice, radiologists and surgeons use the retromandibular vein as a guide to expose the branches of the facial nerve during superficial parotidectomy. Therefore, absence of the retromandibular vein is a hurdle during this procedure and may affect the venous drainage pattern from the head and neck.

Keyword

Retromandibular vein; External jugular vein; Maxillary vein; Variation

MeSH Terms

Anonyms and Pseudonyms
Drainage
Facial Nerve
Head
Jugular Veins*
Neck
Parotid Region*
Veins*

Figure

• 

  Fig. 1 Dissection of temporal and infratemporal regions showing absence of the retromandibular vein, division of the maxillary vein (MV) into anterior (AD) and posterior (PD) divisions, formation of an atypical external jugular vein (AEJV) by the union of the PD and superficial temporal vein (STV), and the presence of an anomalous vein (AV) draining into the internal jugular vein (IJV). ECA, external carotid artery; MA, maxillary artery; SCM, sternocleidomastoid; STA, superficial temporal artery.

• 

  Fig. 2 Illustration of variant venous pattern in the present case. The retromandibular vein is absent, resulting in the division of maxillary vein, abnormal formation of the external jugular vein, and persistence of an anomalous vein.

Reference

1. Williams PL, Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE, Ferguson MW. Gray's anatomy. 38th ed. New York: Churchill Livingstone Inc.;1995. p. 1576–1580.

2. Bertha A, Suganthy R. Anatomical variations in termination of common facial vein. J Clin Diagn Res. 2011; 5:24–27.

3. Balachandra N, Padmalatha K, Prakash BS, Ramesh BR. Variation of the veins of the head and neck: external jugular vein and facial vein. Int J Anat Var. 2012; 5:99–101.

4. Poynter CW. Congenital anomalies of the arteries and veins of the human body with bibliography. Vol. 22. Lincoln: The University of Studies of the University of Nebraska;1922.

5. Padget DH. The development of the cranial venous system in man: from the viewpoint of comparative anatomy. Contrib Embryol. 1957; 247:79–153.

6. Standring S, Ellis H, Healy JC, Johnson D, Williams A, Collins P, Wigley C. Gray's anatomy: the anatomical basis of clinical practice. 39th ed. Edinburgh: Churchill Livingstone;2005. p. 609–618.

7. Choudhary S, Sharma AK, Singh H. Undivided retromandibular vein continuing as external jugular vein with facial vein draining into it: an anatomical variation. JK Sci. 2010; 12:203–204.

8. Gupta N, Jain P, Anshu A, Samta . An undivided retro-mandibular vein receiving facial and posterior auricular vein: case report and clinical repercussion. Indian J Basic Appl Med Res. 2013; 2:710–715.

9. Pai M, Vadgaonkar R, Prabhu L, Shetty P. The different termination patterns of the facial vein: a cadaveric study. Fırat Tıp Dergisi. 2008; 13:32–34.

10. Vollala VR, Bolla SR, Pamidi N. Important vascular anomalies of face and neck: a cadaveric study with clinical implications. Firat Tip Dergisi. 2008; 13:123–126.

11. Kawakami S, Tsukada S, Taniguchi W. The superficial temporal and retromandibular veins as guides to expose the facial nerve branches. Ann Plast Surg. 1994; 32:295–299.

12. Skandalos IK, Amvrosiadias DM, Christodoulou A, Evangelou IN, Ditsias FK, Karamoshos KN. Catheterization of external jugular vein for hemodialysis. Khirurgiia (Mosk). 2005; 11:47–50.