Nana Petroula, Gkrinia Eleni, Maiou Chara, Karyda Ourania, Korais Christos, Spanos Konstantinos, Kouvelos Georgios
Vascular Surgery Department, Larissa University Hospital, University of Thessaly, Larissa, Greece.
Otorhinolaryngology Department - Head and Neck Surgery, University Hospital of Larissa, University of Thessaly, Larissa, Greece.
Vascular. 2022 Jun;30(3):590-595. doi: 10.1177/17085381211013950. Epub 2021 May 22.
Aneurysms of the jugular vein system are rare and high clinical suspicion is needed for diagnosis. External jugular vein aneurysms (EJVA) are considered innocent lesions that need treatment mainly for aesthetic reasons. The aim of this systematic review was to present current literature regarding diagnosis and management of EJVAs.
A literature review was conducted through the Pubmed/Medline and Scopus regarding articles referring on EJVA from 2000 to 2020. Using the PRISMA guidelines (Preferred Reporting Items for Systematic reviews and Meta-Analyses), 30 articles were identified, according to inclusion criteria. Demographics, clinical characteristics, etiology, diagnostic imaging, complications, treatment, and histopathological findings were recorded and analyzed.
Twenty-seven case reports and one case series were identified, including 30 patients and 31 EJVAs. One-third of patients (30.3%) were < 18 years old (mean age 32 years, range 1-72 years) and 54% of them were females. In 51% of the cases, the lesion was characterized as a true aneurysm after histological evaluation. The presence of a soft cervical mass was the most common clinical symptom, while Valsalva maneuver pointed out the presence of an EJVA in 66.7% of patients. Diagnosis was achieved using ultrasonography, computed tomography, or magnetic resonance imaging. Forty-three percent of the patients underwent more than one radiological examination. Twenty patients underwent surgical management. The primary indication of surgical treatment was aesthetic reasons (11/20, 55%). Thrombosis was the most common EJVA complication (11/30, 36.3%).
Differential diagnosis of neck mass should include EJVA. High clinical suspicion and adequate imaging are important for diagnosis. Open surgical approach is the more commonly applied therapeutic strategy.
颈静脉系统动脉瘤较为罕见，诊断需要高度的临床怀疑。颈外静脉动脉瘤（EJVA）被认为是良性病变，主要出于美观原因才需要治疗。本系统评价的目的是呈现有关EJVA诊断和管理的当前文献。
通过Pubmed/Medline和Scopus对2000年至2020年提及EJVA的文章进行文献综述。根据纳入标准，使用PRISMA指南（系统评价和Meta分析的首选报告项目）确定了30篇文章。记录并分析了人口统计学、临床特征、病因、诊断性影像学、并发症、治疗和组织病理学结果。
确定了27例病例报告和1例病例系列，包括30例患者和31个EJVA。三分之一的患者（30.3%）年龄小于18岁（平均年龄32岁，范围1至72岁），其中54%为女性。在51%的病例中，经组织学评估病变被判定为真性动脉瘤。颈部软性肿块是最常见的临床症状，而瓦尔萨尔瓦动作在66.7%的患者中提示存在EJVA。通过超声、计算机断层扫描或磁共振成像进行诊断。43%的患者接受了不止一次放射学检查。20例患者接受了手术治疗。手术治疗的主要指征是美观原因（11/20，55%）。血栓形成是最常见的EJVA并发症（11/30，36.3%）。
颈部肿块的鉴别诊断应包括EJVA。高度的临床怀疑和充分的影像学检查对诊断很重要。开放手术方法是更常用的治疗策略。
