RESUMEN
Objective To discuss the diagnosis and treatment of jugular phlebectasia. Methods Clinical data of 13 patients with jugular phlebectasia were reviewed. The confirmation of diagnosis in the nature, range, and degree of jugular phlebectasia was made using the Valsalva maneuver, color ultrasonography, and enhancement radiological techniques. Except 2 patients with superior mediastinal tumor were transfered to the Department of Thoracic Surgery, the treatment included resection of phlebangioma in 5 patients, internal jugular vein dilatation by balloon catheter in 1 patient, jugular venoplasty in 1 patient, and conservative treatment with Aspirin in 4 patients. Results In 7 surgically treated patients, the postoperative recovery was uneventful and no complications occurred. The length of hospital stay was 2~7 days (mean, 3 d). Follow-up observations in the 7 patients for 3~32 months (mean, 14.4 months) found no recurrence and excellent cosmetic outcomes. In 4 patients receiving conservative therapy, follow-up observations were carried out for 3~55 months. No changes were observed in 3 asymptomatic patients on the dilatation extent of the internal jugular vein and the range of the lesions, while improvements were achieved in 1 patient with symptoms after symptomatic treatment. Conclusions The diagnosis of jugular phlebectasia should be made for the patients who presented with a soft cystic fluctuant mass on the anterior neck which became more prominent during the Valsalva manoeuvre. The confirmation of differential diagnoses in the nature, range and degree of jugular phlebectasia can be made by enhancement radiological examinations. Minimally invasive surgery is recommended for the patients with symptomatic and cosmetic purposes.
RESUMEN
Phlebectasia is an abnormal dilatation of an isolated vein and a rare venous anomaly and is usually asymptomatic. Internal jugular phlebectasia is a localized, nonpulsatile, nontender, compressible, and saccular or fusiform dilatation that enlarges with Valsalva maneuver, sneezing, coughing and straining which increases intrathoracic pressure. Internal jugular phlebectasia predominantly affects young children and its etiology is idiopathic in most cases, but several predisposing factors have been suggested. Although histopathological findings of most cases had no significant abnormality, those of some cases showed elastic dysplasia, focal intimal thickening and muscular defect within the wall of the vein. A swelling in the neck which enlarges with Valsalva maneuver must be differentiated from other diseases. Internal jugular phlebectasia is most likely to be mistaken for laryngocele, superior mediastinal cyst or branchial cleft cyst. Diagnosis should be as non-invasive as possible because no treatment is indicated for this benign self-limiting condition. We present a case of bilateral internal jugular phlebectasia of which diagnosis was made by sonography with doppler technique and neck CT.