A case of the accessory nerve passing through the internal jugular vein

Abstract

Modified radical neck dissection with preservation of the accessory nerve is often used for elective neck dissection or early-stage neck metastasis.
Dissection of the upper neck, requires confirmation of several anatomical landmarks, such as the internal jugular vein, occipital artery, hypoglossal nerve, accessory nerve, vagus nerve, and digastric muscle. During the dissection, surgeons should be aware that the anatomical relations of these landmarks can vary.
After the accessory nerve leaves the jugular foramen, it crosses the internal jugular vein and descends obliquely to the trapezius muscle.
Variations in the relation of the accessory nerve to the internal jugular vein should be taken in account to perform the dissection correctly.
We encountered a patient in whom the accessory nerve passed through the internal jugular vein.