open access

Vol 72, No 4 (2013)
CASE REPORTS
Published online: 2013-12-10
Submitted: 2013-04-05
Accepted: 2013-05-24
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Anatomic variability in the relation between the retromandibular vein and the facial nerve: a case report, literature review and classification

M. Piagkou, M. Tzika, G. Paraskevas, K. Natsis
DOI: 10.5603/FM.2013.0062
·
Folia Morphol 2013;72(4):371-375.

open access

Vol 72, No 4 (2013)
CASE REPORTS
Published online: 2013-12-10
Submitted: 2013-04-05
Accepted: 2013-05-24

Abstract

Knowledge of anatomic variations concerning head and neck veins is important to surgeons performing interventions in these regions, as well as to radiologists. The retromandibular vein is used as a guide to expose the facial nerve branches inside the parotid gland, during parotid surgery and open reduction of mandibular condyle fractures. It is also used as a landmark for localisation of the nerve and compartmentalisation of parotid gland lesions preoperatively, during computed tomography, magnetic resonance imaging and sonography. In this paper, the anomalous retromandibular vein’s course on the left side of a male cadaver is described. The vein was formed around the nerve, while the maxillary vein travelled medial to the facial nerve branches and superficial to the superficial temporal vein. Interestingly, the facial nerve temporofacial division crossed again the superficial temporal vein upwards, forming a “nerve fork”. The incidence of the reported variability of the relationship between the retromandibular vein and the facial nerve are discussed with a detailed literature review. Accordingly, the typical deep position of the retromandibular vein in relation to the facial nerve is estimated to 88.17% to all sides. Furthermore, an updated classification system is proposed, including 4 types and subtypes.

Abstract

Knowledge of anatomic variations concerning head and neck veins is important to surgeons performing interventions in these regions, as well as to radiologists. The retromandibular vein is used as a guide to expose the facial nerve branches inside the parotid gland, during parotid surgery and open reduction of mandibular condyle fractures. It is also used as a landmark for localisation of the nerve and compartmentalisation of parotid gland lesions preoperatively, during computed tomography, magnetic resonance imaging and sonography. In this paper, the anomalous retromandibular vein’s course on the left side of a male cadaver is described. The vein was formed around the nerve, while the maxillary vein travelled medial to the facial nerve branches and superficial to the superficial temporal vein. Interestingly, the facial nerve temporofacial division crossed again the superficial temporal vein upwards, forming a “nerve fork”. The incidence of the reported variability of the relationship between the retromandibular vein and the facial nerve are discussed with a detailed literature review. Accordingly, the typical deep position of the retromandibular vein in relation to the facial nerve is estimated to 88.17% to all sides. Furthermore, an updated classification system is proposed, including 4 types and subtypes.

Get Citation

Keywords

retromandibular vein, facial nerve, variation, incidence, classification

About this article
Title

Anatomic variability in the relation between the retromandibular vein and the facial nerve: a case report, literature review and classification

Journal

Folia Morphologica

Issue

Vol 72, No 4 (2013)

Pages

371-375

Published online

2013-12-10

DOI

10.5603/FM.2013.0062

Bibliographic record

Folia Morphol 2013;72(4):371-375.

Keywords

retromandibular vein
facial nerve
variation
incidence
classification

Authors

M. Piagkou
M. Tzika
G. Paraskevas
K. Natsis

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