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International Journal of Morphology

versión On-line ISSN 0717-9502

Int. J. Morphol. v.25 n.3 Temuco sep. 2007

http://dx.doi.org/10.4067/S0717-95022007000300013 

 

Int. J. Morphol., 25(3)555-556, 2007.

CASE REPORT

 

A Rare Termination of Left Common Facial Vein into Left Subclavian Vein. A Case Report

Terminación Rara de la Vena Facial Común Izquierda en la Vena Subclavia Izquierda. Reporte de Caso

 

Prakash Babu B. & Bhagath Kumar Potu

Department of Anatomy, Kasturba Medical College, Manipal, Karnataka - 576104, India.

Dirección para correspondencia


SUMMARY: During routine dissection of head and neck, an unusual drainage in pattern of the veins on the left side of the face was observed in an adult male cadaver. In the present case, he superficial temporal vein united with maxillary vein to form retromandibular vein within the substance of the left parotid gland. The anterior division of retromandibular vein joined with facial vein to form common facial vein that drained into left subclavian vein directly. Knowledge of such variations is important for surgeons performing head and neck surgeries. Facial veins are often grafted into carotid endarterectomy.

KEY WORDS: Facial vein; Retromandibular vein; Anatomical Variation; Carotid endarterectomy.

RESUMEN: Durante una disección de rutina de cabeza y cuello, fue observado en un cadáver aduto masculino un inusual drenaje de los patrones venosos del lado izquierda de la cara. La vena temporal superficial se unía con la vena maxilar formando la vena retromandibular dentro del parénquima de la glándula parótida izquierda. La división anterior de la vena retromandibular se unió a la vena facial formando la vena facial común la cual drenó directamente en la vena subclavia izquierda. El conocimiento de estas variaciones es importante para los cirujanos de cabeza y cuello. A menudo, las venas faciales se injertan en la endarterectomía carotídea.

PALABRAS CLAVE: Vena facial; Vena retromandibular; Variación anatómica; Endarterectomía carotídea.


INTRODUCTION

The complex embryological development of the vascular system often results in a myriad of clinically relevant anomalies. A variation in the drainage pattern of the veins of the face has been observed in the past (Kopuz et al, 1995, Choudhry et al., 1997, Peuker et al., 2001). The standard anatomical description of the veins of the face is of superficial temporal vein uniting with maxillary vein within the substance of the parotid gland to form retromandibular vein. The retromandibular vein divides into anterior and posterior divisions before emerging out from the apex of the parotid gland. The anterior branch joins with the facial vein slightly inferior and anterior to the angle of mandible to form common facial vein that drains into internal jugular vein.

While the posterior division unites with posterior auricular vein to form external jugular vein that drains into subclavian vein. The relevance and importance of varied drainage patterns of the veins of the head and neck warrant attention for their use in surgeries of head and neck involving micro vascular anastomoses.

CASE REPORT

During routine dissection, an unusual drainage in pattern of the veins on the left side of the face was observed in an adult male cadaver. The left common facial vein was found running downwards and terminated into left subclavian vein. The length of the left common facial vein from the level of its formation till its termination into left subclavian vein was about 16 cm. The venous drainage pattern on the right side of the face was found to be normal.


Fig. 1. Showing the abnormal the termination of left common facial vein into left subclavian vein.

DISCUSSION

Deviations in the venous system from the normal pattern are quite common. Like most superficial veins, the external veins of the head and neck are subject to variations in their morphology, size and termination. Variations in the course and termination of the facial veins are not uncommon (Bergman, 1998). Kopuz, described an unusual course of the facial vein which joined the retromandibular vein at a higher level in the parotid gland on the right side of the face Choudhry found that the termination of the facial vein in the external jugular vein occurs in 5% of the individuals. To the best of our knowledge the termination of the common facial vein in the subclavian vein has so far not been documented in the

available literature. Knowledge of the varying venous patterns in the region of the face is important for the surgeons in order to avoid any intra-operative trial and error procedures which might lead to unnecessary bleeding (Nagase et al, 1997). These facial veins may be used as patches for carotid endarterectomy (Sabharwal & Mukherjeed, 1998) and for oral reconstruction. Remembering the varying venous patterns in the head and face region is important to preoperatively evaluate the course and branching patterns of the respective vessels, by means of Doppler Ultrasonography. The embryological basis of the present variation is not known since it is the first case reported so far in the available literature.

 

REFERENCES

Bergman, R. A.; Thompson, S. A.; Afiñ, A. K. & Saadeh, F. A. Compendium of human anatomic variation: catalog, atlas and world literature. Baltimore: Urban & Schwarzenberg, 1988.        [ Links ]

Choudhry, R.; Tuli, A. & Choudry, S. Facial vein terminating in the external jugular vein. An embryological interpretation. Surg. Radiol. Anat., 19:73-7, 1997.        [ Links ]

Kopuz, C; Yavuz, S.; Cumhur, M.; Tftik, S. & Ilgi, S. An unusual coursing of the facial vein. Kaibogaku Zasshi, 70: 20-2, 1995.        [ Links ]

Nagase, T.; Kobayashi, S.; Sekiya, S. & Ohmori, K. Anatomic evaluation of the facial artery and vein using color Doppler ultrasonography. Annals of Plastic Surgery, 39:64-1, 1997.        [ Links ]

Peuker, E. T.; Fischer, G. & Filler, T. J. Correspondence -facial vein terminating in the superficial temporal vein: a case report. J. Anat., 198:509-10, 2001.        [ Links ]

Sabharwal, P. & Mukherjeed, D. Autogenous commomn facial vein or external jugular vein patch for carotid endarterectomy. Cardiovascular Surgery, 6:594-597, 1998.        [ Links ]

 

Correspondence to:

Dr. Prakash Babu. B,
Associate Professor of Anatomy,
Department of Anatomy, Centre for Basic Sciences
Kasturba Medical College,
Madhav Nagar, Manipal-576104
Karnataka, INDIA.

Phone: 91 -0820-2922327 Fax : 91-0820-2570061

E-mail:billakantibabu@yahoo.co.in

Received: 05-04-2007 Accepted: 15-05-2007

 

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