Collateral lymphatic configuration of the internal jugular chain and jugulo-omohyoid nodes.

Minute dissection was performed bilaterally on 178 human adult cadavers (356 sides) in order to investigate the collateral lymphatic configurations of the internal jugular node chain. The superior and inferior collateral pathways identified based on the topographical anatomy of the large collecting vessels in the neck region. The superior collateral pathway (in 99 of 208 sides, 47.6%) consisted of a node chain, lying on the common carotid artery or along the medial edge of the internal jugular vein, connecting the submandibular lymphatics to the jugulo-omohyoid node (JO). In contrast, the inferior collateral pathway (in 63 of 356 sides, 17.7%) consisted of a single large collecting vessel, lying immediately superficial to the inferior deep cervical nodes, and which directly connected the JO to the venous angle region. A short cervical lymphatic trunk arising from the inferior deep cervical nodes, was also observed in the inferior collateral pathway. The JO seemed to be located at a critical position, where it connected the two collateral pathways. These results are discussed in relation to the fascial arrangement and development of the lymphatics in the cervical region.