Turkish Neurosurgery
Cervical venous vascular anatomy for ventriculoatrial shunt applications: anatomical study and surgical approach recommendation
Baris Ozoner1, Ebubekir Akpinar2, Akakin Akin2, Kilic Turker3, Gungor Abuzer4
1Ada Hospital, Neurosurgery, Istanbul,
2Basaksehir Cam and Sakura Hospital, Neurosurgery, Istanbul,
3Bahcesehir University, Neurosurgery, Istanbul,
4Umraniye Research and Education Hospital, Neurosurgery, Istanbul,
DOI: 10.5137/1019-5149.JTN.33796-21.2

Aim:Ventriculoatrial (VA) shunt applications are performed when applying ventriculoperitoneal shunt is not suitable. However, due to variations in the venous anatomy of the neck region and difficulties with venous vascular dissection, this procedure involves the risk of complications. This study aimed to develop an approach for atrial application of VA shunts after revealing the venous anatomy with facial and cervical anatomical dissections.Material and Methods:: Five cephalic cadavers were used in the study. Facial and cervical regions of the cephalic cadavers were examined with layer by layer anatomical dissection. Venous angiography and ultrasonography were performed to obtain additional data on the cervical venous vascular anatomy. Subsequently, we developed an approach for atrial catheter applications.Results:No anatomical variations were detected in the dissections. The common facial vein, which was formed by the facial vein and retromandibular vein, was observed to drain into the internal jugular vein. As a result of dissections and examinations, an incision approximately 2 cm below the mandible, extending from the projection of the submandibular notch to the trace of the angulus mandible, was considered adequate to expose the common facial vein for atrial catheter insertion.Conclusion:The approach described in our study is appropriate for the application of an atrial catheter for VA shunts. Revealing the venous anatomy with examinations contributes to the success of the operation.

Corresponding author : Baris Ozoner