Variations of venous drainage of the thyroid gland and their surgical implications: a narrative review / Drenagem venosa da glândula tireoide e suas implicações cirúrgicas: revisão narrativa

Abstract Diseases of the thyroid are common worldwide, so knowledge of its normal and variant anatomy, especially of the veins of thyroid, is essential for safe and successful surgery involving the anterolateral neck. The aim of this study is to consolidate all information related to venous drainage of the thyroid gland as a ready reference for vascular and endocrine surgeons. The study was conducted at the Department of Anatomy and the literature search was carried out using the Pubmed, Scielo, Researchgate, Medline, and Scopus databases. Various terms related to the thyroid gland and its venous drainage were used to explore the literature. The literature review revealed that the superior and middle thyroid veins have the fewest variations in terms of course and termination while the inferior thyroid vein has the most variations in terms of course and termination. Detailed knowledge of normal and variant anatomy of the thyroid veins is of utmost use for vascular surgeons performing anterolateral neck surgery, especially tracheostomy, a lifesaving procedure, minimizing intraoperative and postoperative complications and morbidity and mortality.

Resumo As doenças da tireoide são comuns em todo o mundo; portanto, o conhecimento tanto da anatomia normal quanto de variações anatômicas, especialmente das veias tireóideas, é essencial para uma cirurgia segura e bem-sucedida da região anterolateral do pescoço. O objetivo deste estudo é consolidar todas as informações relacionadas à drenagem venosa da glândula tireoide para pronta referência a cirurgiões vasculares e endócrinos. O estudo foi realizado no Departamento de Anatomia, e a pesquisa bibliográfica foi realizada nas bases de dados PubMed, SciELO, ResearchGate, MEDLINE e Scopus. Vários termos relacionados à glândula tireoide e sua drenagem venosa foram considerados para busca na literatura. O levantamento da literatura revelou que as veias tireóideas superior e média apresentam as menores variações em termos de trajeto e terminação, enquanto a veia tireóidea inferior apresenta as maiores variações. O conhecimento detalhado da anatomia normal e de variações anatômicas das veias tireóideas é de extrema utilidade para os cirurgiões vasculares na realização de cirurgia anterolateral do pescoço, especialmente traqueostomia, um procedimento que salva vidas, minimizando complicações intra e pós-operatórias, morbidade e mortalidade.

Evaluation of factors affecting the outcome of emergency cerebral arterial thrombectomy based on cerebral angiography imaging features / 中国医师进修杂志

Objective:To analyze the predictors of poor outcomes after emergency intracerebral thrombectomy based on the characteristics of cerebral angiography.Methods:A total of 146 patients with acute ischemic stroke (AIS) who received endovascular treatment in Loudi Central Hospital from March 2019 to February 2022 were included in the study, and digital subtraction angiography (DSA) was performed on the patients. The patients were divided into a good prognosis group (95 cases) and a poor prognosis group (51 cases) by the modified Rankin scale 3 months after operation. Gender, age, time from onset to visit, time from onset to puncture, proportion of intravenous thrombolysis, occlusion site, treatment strategy, National Institute of Health Stroke Scale (NIHSS) score, core infarct volume, ischemic hypoperfusion volume, collateral circulation classification, and venous drainage status were compared between the two groups score; Logistic regression was used to analyze the risk factors affecting the poor prognosis of patients; Receive Operating Characteristic (ROC) curve was used to analyze the predictive value of collateral circulation classification and venous drainage status score for poor prognosis of patients, and the differences in general data and imaging data were compared between groups with different collateral circulation grades and venous drainage status.Results:Compared with the good outcome group, the time from onset to visit, NIHSS score, core infarct volume, ischemic hypoperfusion volume, the proportion of thrombectomy alone, and collateral circulation classification in the poor outcome group [2 (2, 3) levels. 2 (1, 2) level] and venous drainage score [5 (4, 6) points vs. 6 (6, 8) points] increased ( P<0.05), and the proportion of recanalization grade 2b/3 decreased ( P<0.05); NIHSS score, collateral circulation grade and venous drainage status were predictors of poor outcome within 3 months after mechanical thrombectomy ( OR = 2.51, 1.93, 2.61, P<0.05); collateral circulation grade and venous drainage score predicted mechanical thrombectomy in patients with AIS, the area under curve (AUC) of poor outcome after thrombectomy were 0.714 and 0.829, respectively; the time from onset to visit between patients with poor collateral circulation, moderate and good AIS [(236.95 ± 21.03) min, (250.41 ± 21.32) min, (255.72 ± 20.98 min)], core infarct volume [52 (17, 80) ml, 25 (15.5, 30) ml, 15 (10, 25) ml] and venous drainage scores [5 (4, 6) points, 5 (5, 8) points, 5 (5, 8) points] were significantly different ( P<0.05); time from onset to visit in patients with poor venous drainage, moderate and good AIS (234.81 ± 21.22 min), (256.83 ± 20.88) min, (258.97 ± 21.35) min], core infarct volume [17(13, 45) ml, 26(25, 29) ml, 20 (11, 29) ml] and collateral circulation classification [2 (1, 2) level, 2 (1, 3) level, 2 (2, 3) level] were significantly different ( P<0.05). Conclusions:Collateral grading and venous drainage scores based on DSA imaging were predictors of poor outcomes within 3 months of mechanical arterial thrombectomy in patients with AIS.

Anatomía clínica-quirúrgica del plexo venoso vertebral del perro: una revisión de la literatura / Clinical and surgical anatomy of the dog vertebral venous plexus: a literature review

El objetivo de la presente monografía, fue actualizar la anatomía del Plexo Venoso Vertebral (PVV) del perro de relevancia clínico-quirúrgica y asimismo evaluar el cumplimiento de la Nómina Anatómica Veterinaria (NAV). Se realizaron búsquedas electrónicas utilizando 9 bases de datos, donde se revisaron un total de 49 fuentes bibliográficas. De éstas, 20 correspondieron a artículos científicos. El criterio de exclusión fue el de publicaciones con más de 10 años de antigüedad, con excepción de libros de anatomía veterinaria de referencia base. Publicaciones que no estuvieran escritas en inglés, español o portugués, fueron también excluidas. En general, en la literatura revisada, existió consenso de cuáles son los componentes del PVV, junto con una escueta descripción de éste. El componente del PVV que es más ampliamente descrito y con mayor dimensión es el Plexo Vertebral Interno Ventral (PVIV). La función de retorno venoso sanguíneo alternativo hacia el corazón es la más nombrada. La no existencia de válvulas en el PVIV, pudiese ser una condición promotora para la metástasis tumoral a través del PVV. A nivel quirúrgico, la hemorragia del PVV, representa un peligro no despreciable para la vida del paciente. Con respecto a lo revisado y discutido, se puede concluir que: i) a pesar de la escasa descripción anatómica del PVV se pudo comprender cómo éste está compuesto ii) el nivel de evidencia que avala las distintas capacidades funcionales del PVV es bajo, no obstante, la información de la presentación de la hemorragia del PVV en las distintas cirugías es mayor iii) las variadas referencias bibliográficas consultadas no respetaron la NAV actual para describir al PVV.

SUMMARY: This monograph aims to provide an update on the anatomy of the Vertebral Venous Plexus (VVP) of the dog with emphasis on its clinical and surgical relevance and to evaluate compliance of terms in the literature with Nomina Anatomica Veterinaria (NAV). Electronic searches were conducted using 9 databases, where a total of 49 bibliographic sources were reviewed. Of these, 20 consisted of scientific articles. Publications with more than 10 years old were excluded from review, except for basic reference veterinary anatomy books. Publications that were not written in English, Spanish or Portuguese were also excluded. In general, in the literature reviewed, there was consensus on what the components of the VVP are, along with a brief description of VVP. The most widely described component of the VVP is the Ven- tral Internal Vertebral Plexus (VIVP). The function of alternative venous blood return to the heart is the most frequently described. The absence of valves in the VIVP could be a promoting condition for tumor metastasis through the VVP. At the surgical level, VVP hemorrhage represents a non-negligible threat to the patient's survival. With respect to what has been reviewed and discussed, it can be concluded that: i) despite the scarce anatomical description of the VVP, it was possible to understand how it is composed ii) the level of evidence that supports the different functional capacities of the VVP is low, however, the information on the ocurrence of VVP hemorrhage in surgical procedures is greater and iii) the various bibliographical references describing the VVP did not comply with the current NAV.

Surgical management of total cavopulmonary connection procedure in functional single ventricle with separate hepatic venous drainage / 中国胸心血管外科临床杂志

@#Objective    To investigate the management of hepatic vein (HV) in patients with functional single ventricle (FSV) and separate hepatic venous drainage (SHVD) undergoing total cavopulmonary connection (TCPC) and evaluate this kind of surgery. Methods    The clinical data of 32 consecutive patients with SHVD who underwent modified TCPC operation from August 2005 to January 2017 in our center were retrospectively analyzed. There were 25 males and 7 females with an average age of 2-19 (8.0±5.0) years and body weight of 11-66 (25.4±15.8) kg. Results    There were 20 patients with heterotaxy syndrome and 12 patients with other types of FSV. SHVD was diagnosed preoperatively in 27 patients, among whom 20 patients were connected by intra-extracardiac Gore-Tex conduit, and the other 7 patients were connected by extracardiac Gore-Tex conduit. Because of the missed diagnosis of SHVD, the other 5 patients showed severe decrease of blood oxygen saturation in the early postoperative period and underwent re-operation soon. The postoperative blood oxygen saturation was 92.0% (90.0%, 96.0%), central venous pressure was 10-23 (15.5±3.5) mm Hg, mechanical ventilation assisted time was 16.0 (7.5, 24.0) h, and ICU stay time was 3.0 (2.0, 5.5) d. There were 3 early and 1 late deaths. Conclusion    Intra-extracardiac conduit is an effective and feasible modified TCPC operation for patients with FSV and SHVD, while the surgical details need to be formulated in combination with individual anatomical structure. Preoperative missed diagnosis of SHVD must be avoided. Otherwise, after TCPC, a large amount of stealing blood from HV with low circulation pressure into atrium would lead to unacceptable hypoxemia.

Vacuum-assisted venous drainage in adult open-heart surgery: A randomized controlled trial / 中国胸心血管外科临床杂志

@#Objective    To analyze the safety and efficacy of vacuum-assisted venous drainage (VAVD) in cardiac surgery under cardiopulmonary bypass (CPB). Methods    A total of 180 patients from 3 centers between November 17, 2017 and October 1, 2018 were enrolled and randomly assigned to a VAVD group and a gravity drainage (GD) group by 1∶1 ratio. During the open-heart surgery under CPB, the VAVD group completely relied on VAVD, and the GD group used conventional GD. The primary endpoint was arterial flow before CPB, 15 min after aortic cross-clamping and rewarming to 36 °C of nasopharyngeal temperature. The secondary endpoints included hematocrit, hemoglobin concentration, blood product transfusion, etc. The safety endpoint was free hemoglobin concentration, etc. Results    The full analysis set contained 175 patients, 87 in the VAVD group and 88 in the GD group. Patients in the VAVD group were aged 52.8±12.0 years, and males accounted for 55.2%; patients in the GD group were aged 51.4±12.1 years, and males accounted for 59.1%. The demographic characteristics between the two groups were not statistically different. Compared to the GD group, the VAVD group could provide comparable arterial flow in CPB [average of 3 time points, 2.37±0.22 L/(min·m2) vs. 2.41±0.25 L/(min·m2), P=0.271], while not elevating free hemoglobin concentration. Conclusion    VAVD can provide enough venous drainage, while not elevating free hemoglobin concentration or damaging blood.

Analysis of diagnosis and treatment of scimitar syndrome in 13 cases / 中华胸心血管外科杂志

Objective:To investigate the clinical features, diagnosis, treatment and prognosis of Scimitar syndrome.Methods:A retrospective analysis of clinical data of 13 children with scimitar syndrome from January 2013 to November 2020, including clinical symptoms, chest X-ray, echocardiography, cardiac CT and cardiac catheterization prognosis and follow-up.Results:13 children with scimitar syndrome were diagnosed, including 7 girls and 6 boys with a average age of 17 months(21 days to 10 years).3 cases <5 kg in weight. Ten patients presented with the infantile form and 3 with the adult form of scimitar syndrome. 13 infantile form had lower respiratory tract infections, heart failure, and growth retardation, of which 8 cases were with severe pulmonary arterial hypertension. 3 adult form were diagnosed because of heart murmur. 12 cases had coexisting cardiac lesions, including 12 atrial septal defect, 2 patent ductus arteriosus, 1 right ventricular double outlet/ventricular septal defect, 4 right lung and right pulmonary artery dysplasia, 2 right lung dysplasia, 6 additional systemic arterial supply to the right lung. Ten patients had pulmonary venous drainage correction surgery, one patient only underwent right ventricular double-outlet correction, three patients died of severe pulmonary hypertension; one patient lost the opportunity of surgery due to obstructive pulmonary hypertension, and one patient was complicated by nervous system The disease gave up treatment. One corrected case was stenosed during discharge and 2 corrected children became stenotic during follow-ups.Conclusion:Found with the median or dextrocardial heart, recurrent respiratory infections, or unexplained pulmonary hypertension, the possibility of scimitar syndrome should be considered. The combination of echocardiography and cardiac CTA can confirm the diagnosis as soon as possible. The risk factors for mortality included infantile form and severe preoperative pulmonary hypertension. Long-term follow-up is still required after operation, and surgical intervention is required again if necessary.

Real-time three-dimensional echocardiography for evaluation on biventricular volume and function for infants with total anomalous pulmonary venous drainage / 中国医学影像技术

Objective: To explore the feasibility of real-time three-dimensional echocardiography (RT-3DE) for evaluation on biventricular volume and function for children with total anomalous pulmonary venous drainage (TAPVD). Methods: Totally 16 children with simple TAPVD combined with atrial septal defect or patent foramen ovale (TAPVD group) and 19 normal infants( as control group) were recruited. The following indexes, including left ventricular anteroposterior dimension (LVD), right ventricular transverse dimension (RVD), left ventricular ejection fraction by M-mode (LVEF-M), tricuspid annular plane systolic excursion (TAPSE) and peak velocity of tricuspid annulus (TAV) were measured with two-dimensional echocardiography. Then left/right ventricular ejection fraction (LVEF-3DE, RVEF-3DE) obtained by RT-3DE and left/right ventricular end diastolic volume corrected by body surface area (BSA) (LVEDV/BSA, RVEDV/BSA) were measured. The above parameters were compared between 2 groups. Results: RVD, LVEF-M and RVEDV/BSA in TAPVD group were significantly higher than those in control group, whereas LVD, TAPSE, TAV, RVEF-3DE and LVEDV/BSA were lower than in control group (all P0.05). Conclusion: RT-3DE can be used to evaluate biventricular volume and function in children with TAPVD.

The limitation of transthoracic echocardiography in diagnosing partial anomalous pulmonary venous drainage / 中华儿科杂志

Objective@#To improve the diagnostic accuracy of transthoracic echocardiography (TTE) by analyzing its limitations in diagnosing partial anomalous pulmonary venous drainage (PAPVD).@*Method@#This was a retrospective analysis of PAPVD patients seen at the Children′s Hospital of Fudan University from October 1 2006 to October 1 2016. The echocardiographic data were compared to findings on multi-slice spiral CT (MSCT), cardiac catheterization or surgery. The echocardiography machines used were Philip IE33, GE Vivid 7 and Vivid i with frequency ranging from 5.0 MHz to 7.5 MHz. The cardiac structure was analyzed according to Van Praagh segments.@*Result@#A total of 43 cases of PAPVD were enrolled, male∶ female ratio 20∶23 with average age (27.9±21.4) months. Among them, 3 cases were simple PAPVD and 40 cases had other associated congenital heart diseases. TTE was successful in diagnosing 29 cases (67%) while 14 cases were missed. The diagnostic rate for right pulmonary vein drainage into superior vena cava, right atrium, inferior vena cava were 5/10, 17/20, and 3/5 respectively while left pulmonary vein drainage into left innominate vein was only 1/4. Added TTE images to re-exam the 9 of the 14 missed cases, 5 cases of abnormal drainage from right superior pulmonary vein were diagnosed, while 4 cases of drainage from right lower or left pulmonary vein were only picked up by indirect signs.@*Conclusion@#The distance of the pulmonary veins from the routine ultrasound view and the possibility of branch number variation may limit the accuracy of TTE in diagnosing PAPVD, especially for drainage from right lower and left pulmonary vein. But TTE is still the preferred diagnostic method. The diagnostic rate could be increased by paying special attention to non-routine views including the suprasternal fossa, the right parasternal and subcostal area.

Venous drainage patterns of perimesencephalic subarachnoid hemorrhage / 中国脑血管病杂志

Objective To investigate the relationship between the different deep venous drainage patterns in the brain and the perimesencephalic subarachnoid hemorrhage (PMSAH).Methods From January 2014 to January 2017,the clinical data of 90 patients with subarachnoid hemorrhage (SAH) diagnosed and treated in the Second Affiliated Hospital of Anhui Medical University were analyzed retrospectively.Thirty patients with PMSAH were in a PMSAH group and 60 patients with aneurismal SAH were in a control group.Unilateral cerebral hemisphere venous drainage was divided into type A (normal continuous):the basilar vein had deep middle cerebral vein drainage and was drained into the great cerebral vein of Galen;type B (normal discontinuous):there was discontinuous venous drainage between the basal vein and the anterior uncal vein and the posterior Galen vein;type C (primitive variant):did not drained into great cerebral vein of Galen,perimesencephalic vein was drained into the superior petrosal sinus or basal vein was directly drained into the transverse sinus or straight sinus.The different combinations of bilateral cerebral hemisphere venous drainage were divided into normal type drainage (typeⅠ:AA),discontinuous type drainage (types Ⅱ:AB or BB),and primitive type drainage (types Ⅲ:AC,BC,or CC).The differences of venous drainage between the two groups were compared.Results In the PMSAH group,both types Ⅰ and Ⅱ drainages accounted for 26.7％ (n=8 in each type) and type Ⅲ accounted for 46.7％ (n=14).In the control group,typeⅠaccounted for 48.3％ (n=29),type Ⅱ accounted for 28.3％ (n=17),and type Ⅲ accounted for 23.3％ (n=14).There were no significant differences in the distribution of three venous drainage patterns between the two groups (χ2=5.804,P=0.055).However,there was significant difference in the types Ⅲ venous drainage between the two groups (χ2=5.081,P=0.024).Conclusion Most of the deep cerebral venous drainage in patients with PMSAH showed basilar venous drainage into the venous sinuses of dura mater,but not to the large cerebral vein drainage,suggesting the way of primitive drainage into the dural sinus was more prone to rupture compared with that of drainage into large cerebral veins.

Cortical versus Pial Venous Drainage in Dural Arteriovenous Fistula / 신경중재치료의학

No abstract available.

Variaciones anatómicas en el drenaje venoso del cuello / Anatomical variations in the venous drainage of the neck

Resumen Las venas superficiales, especialmente la vena yugular externa, son cada vez más utilizadas para canalización o procedimientos diagnósticos, terapias intravenosas, nutrición parenteral en pacientes debilitados. Las variaciones en el drenaje venoso de la cabeza y cuello son importantes no solamente para los anatomistas y radiólogos, sino también para los cirujanos. Durante una disección de rutina en el Laboratorio de Morfología de la Universidad de Pamplona en un cadáver masculino de 75 años de edad, se encontraron variaciones anatómicas e inusuales patrones de drenaje en la región de cara y cuello, las cuales fueron cuidadosamente disecadas y los detalles morfológicos fueron fotografiados; esas variaciones consistían en: ausencia unilateral de vena yugular externa. La vena lingual, la vena infrahioidea y la vena tiroidea superior tenían conexiones venosas transversas que drenaban en un arco venoso localizado entre la arteria carótida común y la arteria tiroidea superior. Este arco venoso drenaba hacia arriba en la vena facial común y hacia abajo en la vena yugular interna. El conocimiento de las variaciones anatómicas y morfológicas en las venas de cabeza y cuello es esencial para llevar a cabo procedimientos quirúrgicos exitosos en estas regiones.

Abstract The superficial veins, especially the external jugular vein are increasingly used for cannulation or diagnostic procedures, intravenous therapy, parenteral nutrition in debilitated patients. Variations in the venous drainage of the head and neck are important not only for anatomists and radiologists but also for surgeons. During routine dissection in the Laboratory of Morphology, University of Pamplona in a 75 year-old male cadaver in the region face and neck anatomical variations and unusual drainage patterns were found, which were dissected carefully and morphological details were photographed; these variations consisted of unilateral absence of external jugular vein. The lingual vein, the infrahyoid vein and the superior thyroid vein had transverse venous connections that drained into a venous arch located between the common carotid artery and the superior thyroid artery. This draining venous arch upward in the common facial vein and down into the internal jugular vein. Knowledge of the anatomical and morphological variations in the veins of the head and neck is essential to carry out successful surgical procedures in these regions.

Variantes anatómicas de las venas renales / Anatomical variants of the renal veins

Introducción: el drenaje venoso de los riñones se produce a partir de las venas renales que clásicamente se describen como troncos únicos que drenan en las paredes laterales de la vena cava inferior. Objetivo: determinar las características morfológicas de las venas renales. Materiales y métodos: se realizó un estudio cuantitativo, longitudinal, prospectivo, observacional y descriptivo, en 47 bloques, provenientes de cadáveres sin cirugías arteriovenosas aortorenales, enfermedad aórtica aneurismática, ni malformaciones congénitas renoureterales demostrables, en el Hospital Provincial Clínico Quirúrgico Docente Celia Sánchez Manduley, de Manzanillo, provincia Granma. Los bloques fueron lavados, fijados y disecados por el método macroscópico directo. Resultados: Las venas renales fueron únicas en el 61,70 % (18 bloques) de los bloques, siendo más constantes en el lado izquierdo (87,23 %). El recorrido fue prearterial en el 88,18 % de las venas, siendo este recorrido más frecuente en el lado izquierdo (66,03 %). La unión a la vena cava inferior fue en la cara lateral en el 95,46 % de las venas, siendo esta unión más constante en el lado izquierdo (98,11 %). Conclusiones: las venas renales presentan un patrón de variabilidad anatómica bajo. Las variantes a la norma anatómica fueron más frecuentes en el lado derecho, siendo su conocimiento importante en el planeamiento de la cirugía exerética y reconstructiva nefrourológica.

Introduction: the venous drainage of the kidneys is produced beginning from the renal veins that are classically described as unique trunks draining in the lateral walls of the inferior vena cava. The objective of the research was determining the morphological characteristics of the renal veins. Objective: determining the morphological characteristics of the renal veins. Materials and Methods: a quantitative, longitudinal, prospective, observational and descriptive study was carried out in 47 blocks, coming from dead bodies without aorta-renal arterial-venous surgeries, aortic aneurismal disease nor demonstrable reno-ureteral congenital malformations, in the Teaching Surgical-Clinical Provincial Hospital Celia Sanchez Manduley, of Manzanillo, province of Granma. The blocks were washed, fixed and dissected using the direct macroscopic method. Results: the renal veins were unique in 61.7 % (18 blocks) of the blocks, being more constants in the left side (87.23 %). The course was pre-arterial in 88.18 % of the veins, being this course more frequent in the left side (66.03 %). The union to the inferior vena cava was in the lateral side in 95.46 % of the veins, being this union more constant in the left side (98.11 %). Conclusions: the renal veins have a low pattern of anatomical variability. The variants of the anatomical norm were more frequent in the right side, being its knowledge important in the process of planning the exeretic and nephro-urologic reconstructive surgery.

Irrigación e inervación de la articulación temporomandibular: una revisión de la literatura / Irrigation and innervation of the temporomandibular joint: a literature review

El conocimiento de los nervios aferentes, de la irrigación vascular y del drenaje venoso comprometido en la articulación temporomandibular es relevante para entender la fisiología del sistema estomatognático. El objetivo de este estudio fue identificar los vasos sanguíneos y los nervios involucrados en la irrigación e inervación de la ATM, y si los términos utilizados en la literatura científica respetan lo establecido en Terminología Anatomica Internacional (TAI).Se realizó una revisión de la literatura en la que se incluyeron 10 libros y 11 artículos científicos. La mayoría de los autores señalaron que la irrigación de la ATM se lleva a cabo por ramas de la arteria temporal superficial y ramas de la arteria maxilar, que a su vez son ramas de la arteria carótida externa. El drenaje venoso estaría dado por las venas temporales superficiales y por el plexo pterigoideo. La inervación sensitiva provenía del nervio mandibular, ramo del V par craneal y sus ramos auriculotemporal, maseterino y los nervios temporales profundos. Los autores concuerdan en los principales vasos y ramos nerviosos que dan irrigación e inervación a la ATM, aunque también se mencionan otros vasos y nervios menos descritos. El drenaje venoso de la ATM se encuentra escasamente descrito en la literatura.

The knowledge of the afferent nerves, vascular supply and venous drainage of the temporomandibular joint is relevant to understand the physiology of the stomatognathic system. The aim of this study was to identify the blood vessels and nerves involved in the blood supply and innervation of the TMJ, and if the terms used in the scientific literature respects the Terminologia Anatomica. Ten books and 11 scientific articles were included. A literature review was conducted. Most authors suggest that TMJ irrigation is carried out by branches of the superficial temporal artery and branches of the maxillary artery, which are branches of the external carotid artery. The venous drainage would be given by the superficial temporal vein and by the pterygoid plexus. The sensory innervation was given by the mandibular nerve, branch of the V cranial nerve and its branches auriculotemporal, masseteric and the deep temporal nerves. The authors agree on the major vessels and nerve branches that provide irrigation and innervation to the TMJ, although other less described vessels and nerves are also mentioned. The venous drainage of the TMJ is poorly described in the literature.

Effects of two different venous drainage patterns on the prognosis of fetal pulmonary sequestration / 中华超声影像学杂志

Objective To evaluate the effect of two different venous drainage patterns on the prognosis of fetal pulmonary sequestration( PS) . Methods Sixty cases of fetal PS with confirmed venous drainage diagnosed by prenatal ultrasound were retrospectively analyzed . Changes of the volumes of PS lesions and the clinical outcomes were compared between two different venous drainage patterns . Results Among the total 64 cases ,34 cases were pulmonary venous drainage and 30 cases were systemic venous drainage . There was no case combined with any abnormality in pulmonary venous drainage group;whereas , 6 cases combined with other abnormalities in systemic venous drainage group ,between which significant difference was noted( P =0 .02) . In pulmonary venous drainage group ,there was no significant difference in the volumes of PS lesions between at 20-24 weeks′gestational age(WGA) and at 24+1 -30 WGA( P >0 .05) ;but not between at 24+1 -30 WGA or at 20 -24 WGA and at 30+1 -39 WGA ( P 0 .05) . Postnatal respiratory symptoms and postnatal surgery rates were similar between the two groups( P > 0 .05) . Conclusions PS with systemic venous drainage is more likely combined with other abnormalities than PS with pulmonary venous drainage . The lesion volumes of PS with pulmonary venous drainage decreas remarkably during the middle‐late pregnancy . Nevertheless ,the clinical postnatal outcomes are both favorable in the two groups .

Spontaneous Aggressive Conversion of Venous Drainage Pattern in Dural Arteriovenous Fistula Treated with Onyx Embolization

We report a case of dural arteriovenous fistula (DAVF) that showed spontaneous conversion of venous drainage pattern from Borden type II to type III within a four month period of follow-up. Upon admission, the patient presented with aggravated neurologic status and newly developed seizure. After admission, endovascular embolization was performed through the middle meningeal artery with Onyx®. Complete obliteration of dural arteriovenous shunt was confirmed by angiography, and the patient's clinical symptoms improved. Although most cases of DAVF show benign clinical course and conversion pattern, close follow-up is required to detect potential aggravation.

Scimitar syndrome: a rare congenital venolobar anamoly.

Scimitar syndrome is a rare congenital anomaly presenting with partial anomalous pulmonary venous drainage from right lung to inferior vena cava. This is the rarest anomaly seen in 1 to 3 in 100000 births. Embryologically it is thought to be a primary developmental anomaly of lung with secondary anomalous venous drainage. This is seen commonly in right lung and is common in females. Most of the cases are asymptomatic or minimally symptomatised. If symptoms are present patient usually presents with pulmonary hypertension and symptoms of left to right shunt. Clinically this syndrome is diagnosed by chest x- ray by the presence of “Scimitar sign”. Surgical treatment effective in this syndrome.

An Additional Right Renal Vein and Pre Hilar Primary Tributaries of Left Renal Vein: Embryological Basis and Clinical Significance: A Case Report.

In clinical Anatomy, the renal venous system is relatively understudied compared to the arterial system. The present study reports the presence of an Additional renal vein on the right side draining directly into the Inferior venacava and pre hilar primary tributaries of the left renal vein .The above findings were observed in a male cadaver during routine dissection of abdomen for undergraduate students in the Department of Anatomy,Rajarajeswari Medical college and hospital, Bengaluru, Karnataka India. The Anatomical knowledge of renal veins and its variations are of extreme importance for the surgeon who approaches the retroperitoneal region mainly in the face of current frequency of Renal transplant surgeries.Knowledge of Anatomy and Anomalies of Renal veins is necessary for retroperitoneal surgery and venographic procedures in addition to providing safety guidelines for endovascular procedures. In view of immense clinical significance attached to the variations in the renal vascular patterns, the present case has been discussed with emphasis to its embryological basis.

Experimental study of changes in arteriovenous pressure difference on the survival area of reverse island flap / 中华显微外科杂志

Objective To investigate the effects of changing the arteriovenous pressure difference on the survival area of reverse island flap in New Zealand white rabbits models.Methods The saphenous artery and saphenous vein of New Zealand rabbits were selected to design experimental models of reverse island flap.Experi mental rabbits were randomly divided into 4 groups:group A:control group (reserved pedicle integrity of superficial veins);group B:part anastomosis of saphenous artery group (the distal saphenous artery of the flap was cut,then trimmed its original diameter to half and done end-to-end anastomosis);group C:part anastomosis of vein group (distal superficial veins was cut,then trimmed its original diameter to half and done end-to-end anastomosis);group D:ligated superficial veins group (pedicle superficial veins was ligated).After surgery,the flaps were measured by general observation.Blood distribution at different times of the flaps was detected by radionuclide scans.Survival area of the flap was measured to compare the survival rate of flap.Distribution of blood vessels and the state of blood cells were observed by Histological examination.Results The flap survival rate was (82.27-± 11.71)％ in group B,showing significant differences when compared with that group A (47.70-± 11.18)％,group C (47.70 ± 11.18)％ and group D (47.70 ± 11.18)％ (P ＜ 0.05).Radionuclide scans showed that the radioactive material in group B could be seen clearly,the radioactive material in groups A,C and D were a transient existence.Ten days postoperatively,histological observation showed that group B had more capillary regeneration and blood cells remain compared with other groups.Conclusion Increase the blood supply can increase the survival area of the reverse island flap,and simply promote the venous drainage can not effectively improve the survival rate of the flap.

Síndrome da cimitarra: A propósito de três casos singulares / Scimitar syndrome: the purpose of three individual cases

Os autores relatam três casos de síndrome da cimitarra (SC), que em sua forma habitual cursa com drenagem venosa anômala no pulmão direito, de aspecto radiográfico característico, hipoplasia no referido pulmão e dextroposição cardíaca. Enfatizam sobre a radiografia simples do tórax, como principal exame na investigação diagnóstica, e o valor do estudo angiográfico, na elucidação de anomalias vasculares quando houver indicação cirúrgica. Outros exames complementares, como a tomografia computadorizada, são avaliados para a perfeita caracterização dessa síndrome e de suas variantes...

The authors write about three cases of scimitar syndrome which, commonly, releases as an atypical venous drainage of the right lung, with characteristic image, as well as hypoplasia of the same lung and dextropositioned heart. They emphasize the thoracic radiographic image as the most important complementary method of diagnosis and the importance of the angiographic study for the diagnose of vascular abnormalities with surgical indication. Other exams such as computerized tomography are of value in characterization of syndrome and its variants...

A study of venous drainage of thyroid gland in 50 cadavers.

Introduction: The thyroid gland is drain by mainly three vein, superior thyroid vein, middle thyroid vein, inferior thyroid vein. Some time fourth thyroid vein of kocher is also present. Material and Methods: Anatomy of venous drainage of thyroid gland was studied in 50 formalin embalmed cadaver, aged between 60 to 80 years. Dissection method was use for this study. Result and Observation: Middle thyroid vein found to be absent in 12 cases. No abnormality found in superior thyroid vein and inferior thyroid vein. Termination of all veins was traced. Thyroid vein of kocher was not found in any cases. Conclusion: A better understanding of the anatomic variability in superior thyroid vein, middle thyroid vein and inferior thyroid vein may be useful not only to minimize the risk of bleeding, but it also can help to perform a more accurate dissection with the goal of preserving the laryngeal nerves and parathyroid glands, especially because of its location and relationships with other adjacent structures.