Duplication of the external jugular vein: a language barrier of database search in classic anatomical studies

Objective: Many anatomical variations of the superficial veins of the head and neck have been reported throughout the literature. Accordingly, anatomists and surgeons must have a comprehensive understanding of these variations to avoid confusion. Duplication of the external jugular vein (EJV) is occasionally observed during routine cadaveric dissections; however, this variation seems to be reported less often than actual experience suggests. Therefore, to gain a better understanding of its anatomical and clinical implications, an analysis of the available data should be available. Thus, in this article, we reviewed the current available literature for studies reporting duplication of the EJV. Methods: We conducted a search using PubMed and Google Scholar with the following keywords: “duplication of the external jugular vein,” “division of the external jugular vein,” and “fenestration of the external jugular vein,” “double external jugular vein,” and “doubled external jugular vein.” As a case illustration, we also describe a case of a duplicated EJV found during a right neck dissection of a female cadaver. Results: Twenty sides across sixteen different studies were analyzed including the present case. All studies were published between 2009 and 2020. EJV division patterns were classified as either duplication, fenestration, fenestration followed by duplication, or double fenestrations. Conclusions: We have reviewed the literature regarding cases documenting duplication/fenestration of the EJV. As it is often difficult to find recent studies that report on classic anatomical variations, therefore, revisiting older articles and textbooks is necessary for achieving a “comprehensive” review, especially across different languages.