Venous Outflow Obstruction

Venous Outflow Obstruction is the new terminology for IJV compression in the ENT world. It can be caused by the styloid process, the transverse processes of C-1, & sometimes C-2 (rare), scar tissue, muscle/other soft tissues, and other things.

Dr. Costantino has suggested that if you are diagnosed with Eagle Syndrome w/ IJV compression, you address it as Eagle Syndrome with Venous Outflow Obstruction as opposed to Eagle Syndrome with IJV compression. VOO is much more descriptive terminology & may be more useful in helping the patient find a doctor who does the proper surgery to eliminate both problems.

Apparently many people with ES have vascular outflow obstruction but may not realize it. Thus, when a styloidectomy is performed, the surgeon, not being aware of the IJV blood flow issues, won’t take the next step to eradicate the cause. As a result, the constriction is not dealt with, & the surgery is ultimately unsuccessful in symptoms eradication.

I haven’t heard if ICA compression is now Arterial Inflow Obstruction, but it would seem to follow suit.

Advice - when requesting a diagnostic CT scan for ES, let your doctor know you want to be evaluated for ES, vascular, & arterial obstruction. This way you should get a more complete picture of what could be causing your symptoms.


Good one @Isaiah_40_31 but I think Arterial Inflow Obstruction would suit the ICA since the brain is supplied by it. Different naming conventions are used by different doctors so it is good that you pointed it out. I have also heard it referred to as Stylocarotid artery syndrome

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:joy: I was thinking outflow as in the blood can’t flow out of the carotid but your comment is more logical, @KoolDude. I’ll correct it. I’ve heard Stylocarotid Artery Syndrome, but for IJV it’s been Eagle Syndrome w/ Jugular Variant. Someone needs to standardize all these titles!!


Yeah, it depends on the frame of reference. If we make the brain the frame of reference then anything leaving it, we can call it outflow I guess vice versa anything coming in we can call it inflow. Similarly if we make the heart the frame of reference, then anything going out we can call it outflow ( Arteries will be outflow) and anything coming in will be inflow (Veins will be inflow). So you are not wrong calling outflow obstruction either.


To be consistent w/ the IJV outflow (brain), ICA inflow makes more sense.

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Do you are anyone know which of the doctors on the list here are familiar with VOO issues?

Dr. Costantino & Dr. Hepworth are the two we think have the most experience. There may be other ES but their names haven’t landed on our forum yet.