A physiologic approach to the problems of simultaneous bilateral neck dissection

Internal jugular vein thrombosis following modified neck dissection: implications for head and neck flap reconstruction

“…Other morbidity from IJVT also must be realized. [13][14][15][16][17] From our experience, this scenario of a thrombosed jugular vein and flap compromise following a neck dissection and free flap reconstruction is rare, probably less than 1% of cases. Certainly, success rates from free flap transfers to the head and neck exceed 90% to 95% in most series.…”

“…12 Bilateral jugular vein occlusion, either during the course of a bilateral radical neck dissection or bilateral dissection with preservation and subsequent thrombosis, has been shown to be morbid and potentially fatal. [13][14][15][16][17] Outcomes in those patients whose internal jugular vein becomes compromised can include debilitating facial edema, cerebral edema, blindness, and even death. [13][14][15][16][17] The natural history from a unilateral IJVT is unknown.…”

“…[13][14][15][16][17] Outcomes in those patients whose internal jugular vein becomes compromised can include debilitating facial edema, cerebral edema, blindness, and even death. [13][14][15][16][17] The natural history from a unilateral IJVT is unknown. Its presentation is often subclinical, and the potential morbidity relates to the inflammatory thrombophlebitis that ensues and the 5% risk of pulmonary embolism.…”

Factors influencing internal jugular vein patency after neck dissection in oral cancer

“…Patients with bilateral internal jugular vein occlusion can experience serious complications, such as elevated intracranial pressure, visual impairment, SIADH, and sometimes death. [11][12][13][14] The incidence of internal jugular vein stenosis/occlusion in this study was 21.0%, which is relatively high. These results indicate that particular caution should be exercised to prevent internal jugular vein stenosis or occlusion when performing a bilateral MRND or E-SOHND, and in the case of contralateral neck dissection after removal of one internal jugular vein in a previous radical neck dissection.…”

“…[1][2][3][4][5][6][7][8][9][10] Resection, occlusion, or stenosis of the bilateral internal jugular veins is likely to induce serious complications such as elevated intracranial pressure, facial oedema, visual impairment, and the syndrome of inappropriate antidiuretic hormone secretion (SIADH), and can lead to death. [11][12][13][14] Internal jugular vein thrombosis associated with pulmonary embolism is also a frequent complication 15 and may lead to anastomotic thrombosis in free flap reconstruction. [16][17][18] Risk factors for internal jugular vein occlusion and stenosis include technical problems associated with vessel dissection, such as the method of branch ligation, thermal injury to the vein caused by electrocautery, and dryness after outer membrane detachment, 1,8 and aspects of the reconstructive procedure, including pressure in internal jugular veins in the musculocutaneous flap.…”