Skip to main content
SpringerLink
Log in

Biometric measurements involving the terminal portion of the thoracic duct on left cervical level IV: an anatomic study

  • Original Article
  • Published:
Anatomical Science International Aims and scope Submit manuscript

Abstract

To determine the point of entrance of the thoracic duct in the venous system, as well as to evaluate some biometric measurements concerning its terminal portion, we conducted an anatomic study on 25 non-preserved cadavers. The termination of the thoracic duct occurred on the confluence between the left internal jugular vein and the left subclavian vein in 60 % of the individuals. The average results for the biometric measurements were: distance between the end of left internal jugular vein and omohyoid muscle 31.2 ± 2.7 mm; distance between the end of thoracic duct and the left internal jugular vein 0.0 ± 0.0 mm; distance between the end of thoracic duct and the left subclavian vein 3.6 ± 1.0 mm; distance between the end of thoracic duct and the left brachiocephalic vein 10.7 ± 3.1 mm. Moreover, it was identified that the left internal jugular vein length in level IV, measured between its entrance in the left subclavian vein and the omohyoid muscle, was able to predict the termination of the thoracic duct on the junction between the left internal jugular vein and the left subclavian vein (OR = 2.99) with high accuracy (79.3 %). In addition, the left internal jugular vein length at level IV was able to predict the localization of thoracic duct termination. Thus, this finding has practical value in minimizing the risk for a potential chyle leak during or after a left-sided neck dissection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Campisi CC, Boccardo F, Piazza C, Campisi C (2013) Evolution of chylous fistula management after neck dissection. Curr Opin Otolaryngol Head Neck Surg 21:150–156

    Article  PubMed  Google Scholar 

  • Cernea CR, Hojaij FC, De Carlucci D Jr, Tavares MR, Araujo-Filho VJ, Silva-Filho GB, Brandao LG (2012) Abdominal compression: a new intraoperative maneuver to detect chyle fistulas during left neck dissections that include level IV. Head Neck 34:1570–1573

    Article  PubMed  Google Scholar 

  • Hematti H, Mehran RJ (2011) Anatomy of the thoracic duct. Thorac Surg Clin 21:229–238

    Article  PubMed  Google Scholar 

  • Jdanov DA (1959) Anatomy of the thoracic duct and of the main lymphatic vessels of the trunk in man. Acta Anat (Basel) 37:20–47

    Article  CAS  Google Scholar 

  • Kaur D, Jain M, Dhall U, Singh K (2012) An unusual course of the thoracic duct in relation to the vertebral vessels. Singapore Med J 53:e1–e2

    CAS  PubMed  Google Scholar 

  • Kinnaert P (1973) Anatomical variations of the cervical portion of the thoracic duct in man. J Anat 115:45–52

    CAS  PubMed  PubMed Central  Google Scholar 

  • Langford RJ, Daudia AT, Malins TJ (1999) A morphological study of the thoracic duct at the jugulo-subclavian junction. J Craniomaxillofac Surg 27:100–104

    Article  CAS  PubMed  Google Scholar 

  • Merrigan BA, Winter DC, O’Sullivan GC (1997) Chylothorax. Br J Surg 84:15–20

    Article  CAS  PubMed  Google Scholar 

  • Nowak K, Wierzbicka M, Szyfter W (2011) Chylous leakage–rare but still dangerous complication after neck surgery. Otolaryngol Pol 65:128–131

    Article  PubMed  Google Scholar 

  • Phang K, Bowman M, Phillips A, Windsor J (2014) Review of thoracic duct anatomical variations and clinical implications. Clin Anat 27:637–644

    Article  CAS  PubMed  Google Scholar 

  • Shimada K, Sato I (1997) Morphological and histological analysis of the thoracic duct at the jugulo-subclavian junction in Japanese cadavers. Clin Anat 10:163–172

    Article  CAS  PubMed  Google Scholar 

  • Skandalakis JE, Skandalakis LJ, Skandalakis PN (2007) Anatomy of the lymphatics. Surg Oncol Clin N Am 16:1–16

    Article  PubMed  Google Scholar 

  • Smoke A, Delegge MH (2008) Chyle leaks: consensus on management? Nutr Clin Pract 23:529–532

    Article  PubMed  Google Scholar 

  • Vaz MA, Fernandes PP (2006) Chylothorax. J Bras Pneumol 32(Suppl 4):S197–S203

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Head and Neck Surgery Department, Faculty of Medicine, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, 8th floor, room 8174, São Paulo, SP, ZIP: 05403-000, Brazil

    Andressa Cristina Sposato Louzada, Soo Jin Lim, Jaqueline Fabiano Pallazzo, Viviane Passarelli Ramin Silva, Ruan Vitor Silva de Oliveira, Alvaro Masahiro Yoshio, Vergilius José Furtado de Araújo-Neto, Ana Kober Nogueira Leite, André Silveira, Cesar Simões, Lenine Garcia Brandão, Leandro Luongo de Matos & Claudio Roberto Cernea

Authors
  1. Andressa Cristina Sposato Louzada
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Soo Jin Lim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jaqueline Fabiano Pallazzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Viviane Passarelli Ramin Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ruan Vitor Silva de Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alvaro Masahiro Yoshio
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Vergilius José Furtado de Araújo-Neto
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ana Kober Nogueira Leite
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. André Silveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Cesar Simões
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Lenine Garcia Brandão
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Leandro Luongo de Matos
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Claudio Roberto Cernea
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Leandro Luongo de Matos.

Ethics declarations

Conflict of interest

The authors have read and approved the final manuscript and do not have actual, potential, or apparent conflict of interest with regard to the manuscript submitted for review, confirm that the manuscript has been submitted solely to Anatomical Science International and is not submitted, in press, or published elsewhere until the editorial board has decided whether to publish the article.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Louzada, A.C.S., Lim, S.J., Pallazzo, J.F. et al. Biometric measurements involving the terminal portion of the thoracic duct on left cervical level IV: an anatomic study. Anat Sci Int 91, 274–279 (2016). https://doi.org/10.1007/s12565-015-0295-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12565-015-0295-9

Keywords

Search

Navigation