ABSTRACT
Superior cervical ganglion (SCG), the largest of the three cervical sympathetic ganglia, is formed by the fusion of first four cervical ganglia. Bilaterally elongated superior cervical ganglion was observed in a female cadaver during dissection. On the right side, it was 63.74 mm long and 5.75 mm wide and on the left side, it was 62.88 mm and 5.84 mm respectively. Histological analysis of the ganglion done with toluidine blue staining confirmed the structure of sympathetic ganglion. Superior cervical ganglion is the preferred ganglion for sympathetic block in conditions like trigeminal neuralgia, atypical facial pain,and post-herpetic neuralgia. Even though superior cervical ganglion has been reported to be at the safest location, thetension of sympathetic trunk while retracting the carotid sheath during surgeries might result in Horner’s syndrome. Furthermore, a large ganglion may also be confused with deep cervical lymph nodes or retropharyngeal mass during imaging studies. Understanding the variant anatomy of the superior cervical ganglion might serve as a guide for imaging studies, cervical spine surgeries,and sympathetic block.
ABSTRACT
External jugular vein is the superficial vein of the neck and is prone to variations. Multiple internal jugular veins are incidental findings that present as a duplication or fenestration. We encountered a unilateral fenestrated internal jugular vein and a bilateral variation in the course of external jugular vein, during a cadaveric dissection. The external jugular vein, after its formation, crossed the sternocleidomastoid muscle and pierced the investing cervical fascia of the posterior triangle. It traversed deep to the inferior belly of omohyoid muscle to enter the subclavian triangle and terminated by draining into the subclavian vein on the left side, and at the angle between the internal jugular vein and the subclavian vein on the right side. The fenestrated internal jugular vein on the left side divided into a small medial and large lateral division which reunited at the level of the tendon of omohyoid muscle and drained into the subclavian vein. Only the medial division of the internal jugular vein received tributaries in the neck. Awareness of the multiple variations of the jugular veins would be valuable during surgical approaches to the neck. Present report aims to be useful for vascular surgeons, radiologists, and intensivists as well.