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Updated: Jul 9, 2026
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Intravital Microscopy of the Inguinal Lymph Node
Published on: April 4, 2011
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Lymph node transfer using the middle jugular lymph node flap: Anatomical study and a report of two cases
Fumio Onishi1, Bien-Keem Tan2,3
1Department of Plastic Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
JPRAS Open
|May 19, 2025
Summary
The middle jugular region offers a viable donor site for lymph node transfer in lymphedema treatment. Anatomical study confirms reliable blood supply from the superior thyroid artery for successful vascularized lymph node flaps.
Area of Science:
- Vascular anatomy
- Microsurgery
- Lymphedema treatment
Background:
- The middle jugular region is explored as a donor site for lymph node harvesting.
- Vascularized lymph node transfer outcomes depend on lymph node quantity and vascular integrity.
- Understanding the vascular anatomy is crucial for optimizing lymph node flap procedures.
Purpose of the Study:
- To clarify the vascular anatomy of the middle jugular lymph node flap.
- To explore the clinical applications of this flap in treating lymphedema.
Main Methods:
- Dissection of nine cadaveric hemi-necks to map lymph node blood supply and anatomical relationships.
- Clinical application of the middle jugular lymph node flap based on anatomical findings.
Main Results:
- An average of two lymph nodes were identified in the middle jugular region.
- The superior thyroid artery branches (sternocleidomastoid, superior laryngeal) were primary blood supply sources.
- Hilar veins drained into the facial vein, internal jugular vein, or superior thyroid vein.
- Successful clinical application in extremity lymphedema cases with no major complications.
Conclusions:
- The middle jugular region is a favorable donor site for lymph node transfer.
- Straightforward surgical access and reliable vascular pedicle from the superior thyroid artery.
- The anatomical findings support the clinical utility of this lymph node flap.
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