Unusual Termination of the Facial Vein into External Jugular Vein and its Clinical Implication

Abstract

The superficial veins of the neck are used for cannulation, either for intravenous infusion or for central venous pressure
monitoring. Variations in the venous system from the normal pattern are relatively common. We present some unusual
variations of the facial vein draining into the external jugular vein instead of draining into the internal jugular vein. The
external jugular vein usually begins just behind the angle of the mandible by the union of the posterior auricular vein with the
posterior division of the retromandibular vein and then descends obliquely across the sternocleidomastoid muscle and, just
above the clavicle, pierces the deep fascia and drains into the subclavian vein. External jugular vein gives a reliable estimate
of central venous pressure. The variation may give false value of pressure due to facial vein draining into it, also may create
difficulty in catheterization. It’s very important not only for anatomists but also for head and neck surgeons to be aware of the
possible anatomical variation in the formation of external jugular Vein and its clinical implications.