Anatomical variations in internal jugular vein splitting patterns: a theoretical framework for a classification...

Area of Science:

• Anatomy
• Vascular Surgery
• Radiology

Background:

• The internal jugular vein (IJV) shares the carotid sheath with the common carotid artery and vagus nerve.
• Variations like fenestration, bifurcation, and duplication of the IJV are common incidental findings.
• Current terminology for these IJV variations is inconsistent, leading to ambiguity.

Purpose of the Study:

• To establish a standardized classification system for internal jugular vein variations.
• To redefine terminology for IJV fenestrations, bifurcations, and duplications.
• To improve anatomical understanding and precision in medical literature and practice.

Main Methods:

• Utilized three anatomical landmarks: posterior belly of the digastric muscle, hyoid bone, and intermediate tendon of the omohyoid muscle.
• Divided the IJV into four distinct anatomical levels.
• Defined fenestration, bifurcation, partial duplication, and total duplication based on IJV splits across these levels.

Main Results:

• A novel classification system for IJV variations was proposed.
• Fenestration defined as splits within a single level.
• Bifurcation across two levels, partial duplication across three, and total duplication across all four levels.
• The classification accommodates parallel or multi-level venous splits and rare variations.

Conclusions:

• The proposed classification provides a uniform terminology for IJV variations.
• This framework enhances anatomical understanding and precision for radiologists and surgeons.
• Standardized terminology is crucial for consistent reporting and interpretation of IJV anatomical variations.