Anatomical relationship between the omohyoid muscle and the internal jugular vein on ultrasound guidance

Abstract

Background: Internal jugular vein catheterization is widely used in clinical practice, and there are many related studies on internal jugular vein catheterization. However, the omohyoid muscle, which is adjacent to the internal jugular vein, is a rarely mentioned muscle of the infrahyoid muscles group. The purpose of this study is to explore the anatomical relationship between the omohyoid muscle and the internal jugular vein on ultrasound guidance and provide a theoretical reference for jugular puncture and catheterization. Methods: The study included 30 volunteers. The volunteer’s head lay in the neutral position and was then turned to the left at an angle of 30°, 45° and 60° with the bed surface, as verified using an adjustable protractor. A high-frequency ultrasound probe (6–14 Hz) was used to examine the plane of the apex of sternocleidomastoid triangle (PAST), the triangle consists of anatomical landmarks: a base was clavicle, its sides – heads of sternocleidomastoid muscle. And the plane of the middle of sternocleidomastoid triangle(PMST) which was a horizontal line, connecting midpoints of both sides. The right omohyoid muscle (OM) and the right internal jugular vein (IJV) were observed and recorded for statistical analysis. Results: There were statistically significant differences in the number of overlapping cases of OM and IJV at each head rotation angle between the PAST and PMST groups. There were statistically significant differences between the angles which OM and IJV centre point line and the left horizontal position of the PAST and PMST at different body angles. Conclusion: The traditional middle route puncture point is the apex of the sternocleidomastoid triangle, which can effectively avoid injury to the omohyoid muscle, to an extent. Trail registration: ChiCTR2000034233, Registered 29/06/2020. www. Chinese Clinical Trial Registry.gov.