The omohyoid muscle entrapment of the internal jugular vein. A still unclear pathogenetic mechanism
Sergio Gianesini1, Erica Menegatti1, Francesco Mascoli2,
Fabrizio Salvi3, Stefano Bastianello4 and Paolo Zamboni1
Objectives: To evaluate the role of the omohyoid muscle anatomic variants as a possible reversible cause of internal
jugular vein extrinsic compression.
Method: We describe a chronic cerebro-spinal venous insufficiency patient, who presented a omohyoid muscle entrapment
of the internal jugular vein, confirmed by both magnetic resonance venography and ultrasound investigation.
A omohyoid muscle surgical transection together with a patch angioplasty was performed.
Results: The surgical procedure led to both IJV flow restoration and neurological improvement.
Conclusions: The omohyoid muscle compression on the internal jugular vein seems to be a possible cause of venous
obstruction, but several anatomical and patho-physiological aspects need further investigations. Such picture might cause
balloon venous angioplasty inefficacy and needs to be preoperatively considered.
Two things were treated: a muscle was snipped that was compressing the jugular, and the jugular itself underwent a patch angioplasty, which is when the jugular is cut lengthwise and a patch of additional vein is sewn in to make the jugular bigger.
Since both a patch angioplasty and a muscle transection occurred, then we don't know which of the two procedures gets the credit for the neurological and blood flow improvements, but there were improvements!