{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:58:40Z","timestamp":1760151520288,"version":"build-2065373602"},"reference-count":23,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T00:00:00Z","timestamp":1648166400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Until recently, vascularized lymph-node flaps were based on arterial and venous donor vessels. Now, venous lymph-node flaps form a novel promising concept in the treatment of advanced-stage lymphedema. In preliminary studies, the external jugular vein has shown promising results as a venous lymph-node flap. However, nothing is known about the number of lymph nodes adjacent to the external jugular vein. Methods: Standardized specimens of the external jugular vein and surrounding fatty tissue directly overlying the sternocleidomastoid muscle were obtained during routine neck dissection. Histologic evaluation was performed in order to evaluate for the presence of lymph nodes within the tissue. Results: A total of 20 specimens were evaluated. There was no vein in 4 of the samples. We found lymph nodes in 9 of the remaining 16 samples. In 7 samples, lymph nodes were absent. Conclusion: Our results suggest that the vein directly overlying the sternocleidomastoid muscle may not be the ideal candidate for a venous lymph-node flap.<\/jats:p>","DOI":"10.3390\/jcm11071812","type":"journal-article","created":{"date-parts":[[2022,3,27]],"date-time":"2022-03-27T21:27:51Z","timestamp":1648416471000},"page":"1812","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluation of the External Jugular Vein Overlying the Sternocleidomastoid Muscle as Venous Lymph-Node Flap"],"prefix":"10.3390","volume":"11","author":[{"given":"Lorenz","family":"Kadletz-Wanke","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felicitas","family":"Oberndorfer","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Grabner","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Kenner","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Unit of Pathology of Laboratory Animal Pathology, University of Veterinary Medicine, 1090 Vienna, Austria"},{"name":"Ludwig Boltzmann Institute for Cancer Research, 1090 Vienna, Austria"},{"name":"CBMed Core Lab2, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus F.","family":"Schr\u00f6gendorfer","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, University Hospital Sankt Poelten, 3100 St. P\u00f6lten, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregor","family":"Heiduschka","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1093\/qjmed\/hcg126","article-title":"Lymphoedema: An underestimated health problem","volume":"96","author":"Moffatt","year":"2003","journal-title":"QJM"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1196\/annals.1413.014","article-title":"Estimating the Population Burden of Lymphedema","volume":"1131","author":"Rockson","year":"2008","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_3","unstructured":"WHO (2017). Weekly Epidemiological Record, WHO."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1200\/JCO.21.01681","article-title":"Prospective Surveillance for Breast Cancer\u2013Related Arm Lymphedema: A Systematic Review and Meta-Analysis","volume":"40","author":"Rafn","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1177\/1358836X9800300209","article-title":"Lymphedema: Classification, diagnosis and therapy","volume":"3","author":"Szuba","year":"2016","journal-title":"Vasc. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/S1051-0443(07)61988-5","article-title":"Diagnosis and treatment of concomitant venous obstruction in patients with secondary lymphedema","volume":"13","author":"Szuba","year":"2002","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_7","first-page":"28","article-title":"The Influence of Local Hyperthermia on Lymphedema and Lymphedematous Skin of the Human Leg","volume":"26","author":"Liu","year":"1993","journal-title":"Lymphology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1200\/JCO.2003.04.069","article-title":"Effect of Upper Extremity Exercise on Secondary Lymphedema in Breast Cancer Patients: A Pilot Study","volume":"21","author":"McKenzie","year":"2003","journal-title":"J. Clin. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1055\/s-2006-947150","article-title":"Supermicrosurgical Lymphaticovenular Anastomosis for the Treatment of Lymphedema in the Upper Extremities","volume":"16","author":"Koshima","year":"2006","journal-title":"J. Reconstr. Microsurg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1097\/PRS.0b013e31819e6529","article-title":"Vascularized Groin Lymph Node Transfer Using the Wrist as a Recipient Site for Management of Postmastectomy Upper Extremity Lymphedema","volume":"123","author":"Lin","year":"2009","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.cps.2012.08.002","article-title":"Microlymphatic Surgery for the Treatment of Iatrogenic Lymphedema","volume":"39","author":"Becker","year":"2012","journal-title":"Clin. Plast. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.ygyno.2012.04.017","article-title":"A novel approach to the treatment of lower extremity lymphedema by transferring a vascularized submental lymph node flap to the ankle","volume":"126","author":"Cheng","year":"2012","journal-title":"Gynecol. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1097\/PRS.0b013e31828bd3b3","article-title":"Vascularized Groin Lymph Node Flap Transfer for Postmastectomy Upper Limb Lymphedema: Flap Anatomy, Recipient Sites, and Outcomes","volume":"131","author":"Cheng","year":"2013","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1055\/s-0036-1584527","article-title":"The Venous Lymph Node Flap: Concepts, Experimental Evidence, and Potential Clinical Implications","volume":"32","author":"Constantinescu","year":"2016","journal-title":"J. Reconstr. Microsurg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1002\/micr.30036","article-title":"The venous lymph node flap for the treatment of peripheral lymphedema: Preliminary evidence","volume":"37","author":"Visconti","year":"2017","journal-title":"Microsurgery"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1097\/00006534-198103000-00009","article-title":"Flaps nourished by arterial inflow through the venous system: An experimental investigation","volume":"67","author":"Nakayama","year":"1981","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1002\/jso.24966","article-title":"Alternative vascular constructs of lymph node flap transfer","volume":"117","author":"Nicoli","year":"2018","journal-title":"J. Surg. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"192e","DOI":"10.1097\/01.prs.0000437257.78327.5b","article-title":"The Mechanism of Vascularized Lymph Node Transfer for Lymphedema: Natural Lymphaticovenous Drainage","volume":"133","author":"Cheng","year":"2014","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1055\/s-0034-1381957","article-title":"From Theory to Evidence: Long-Term Evaluation of the Mechanism of Action and Flap Integration of Distal Vascularized Lymph Node Transfers","volume":"31","author":"Patel","year":"2014","journal-title":"J. Reconstr. Microsurg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"041","DOI":"10.1055\/s-0037-1606320","article-title":"Quantity of Lymph Nodes in the Vascularized Lymph Node Transfer Influences Its Lymphaticovenous Drainage","volume":"34","author":"Kwiecien","year":"2017","journal-title":"J. Reconstr. Microsurg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1002\/micr.22388","article-title":"Quantity of lymph nodes correlates with improvement in lymphatic drainage in treatment of hind limb lymphedema with lymph node flap transfer in rats","volume":"36","author":"Nguyen","year":"2016","journal-title":"Microsurgery"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1007\/s00276-014-1398-z","article-title":"A case of left-sided absence and right-sided fenestration of the external jugular vein and a review of the literature","volume":"37","author":"Cvetko","year":"2014","journal-title":"Surg. Radiol. Anat."},{"key":"ref_23","first-page":"99","article-title":"Variation of the veins of the head and neck\u2013External jugular vein and facial vein","volume":"5","author":"Balachandra","year":"2012","journal-title":"Int. J. Anat. Var."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/7\/1812\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:43:02Z","timestamp":1760136182000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/7\/1812"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,25]]},"references-count":23,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["jcm11071812"],"URL":"https:\/\/doi.org\/10.3390\/jcm11071812","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2022,3,25]]}}}