External or Internal Jugular Vein? Recipient Vein Selection in Head and Neck Free Tissue Transfer

Cheng, Hsu-Tang; Lin, Fu-Yu; Chang, Sophia Chia-Ning

doi:10.1097/prs.0b013e318245ead9

Cited by 21 publications

(13 citation statements)

References 5 publications

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“…The EJV may be less optimal because its superficial location increases the susceptibility to external compression. However, a meta‐analysis on this topic reviewed 1409 flaps, and no statistical difference was found in venous thrombosis rates (4.83% in IJV vs 5.25% in EJV) …”

Section: Discussionmentioning

confidence: 99%

Controversies in free tissue transfer for head and neck cancer: A review of the literature

et al. 2019

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Background Microvascular free tissue transfer provides superior functional outcomes when reconstructing head and neck cancer defects. Careful patient selection and surgical planning is necessary to ensure success, as many preoperative, intraoperative, and postoperative patient and technical factors may affect outcome. Aims To provide a concise, yet thorough, review of the current literature regarding free flap patient selection and management for the patient with head and neck. Materials and Methods PubMed and Cochrane databases were queried for publications pertaining to free tissue transfer management and outcomes. Results Malnutrition and tobacco use are modifiable patient factors that negatively impact surgical outcomes. The use of postoperative antiplatelet medications and perioperative antibiotics for greater than 24 hours have not been shown to improve outcomes, although the use of clindamycin alone has been shown to have a higher risk of flap failure. Liberal blood transfusion should be avoided due to higher risk of wound infection and medical complications. Discussion There is a wide range of beliefs regarding proper management of patients undergoing free tissue transfer. While there is some data to support these practices, much of the data is conflicting and common practices are often continued out of habit or dogma. Conclusion Free flap reconstruction remains a highly successful surgery overall despite as many different approaches to patient care as there are free flap surgeons. Close patient monitoring remains a cornerstone of surgical success.

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Section: Discussionmentioning

confidence: 99%

Controversies in free tissue transfer for head and neck cancer: A review of the literature

et al. 2019

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“…The significance of this finding in a male is relevant from both anatomical and clinical perspectives. The EJV is increasingly being used as the recipient vein for head and neck tissue transfers [2]. Furthermore, the superficial veins of the neck are gathering popularity for purposes of cannulation to conduct diagnostic procedures and intravenous therapies [1].…”

Section: Discussionmentioning

confidence: 99%

“…Knowledge of variation in the venous trees of the head and neck is important for both a clinician and anatomist, with neck veins being increasingly used as recipients of free autologous tissue transfers as well as in diagnostic procedures and intravenous therapies [1,2]. There have been several case reports of variation in external jugular vein (EJV) anatomy [3][4][5][6][7] but no study has yet reported the anomaly in a male.…”

Section: Introductionmentioning

confidence: 99%

A case of unilateral fenestration of the external jugular vein in a male cadaver with a review of existing literature

Matthew¹,

Robert²,

Isabel³

et al. 2019

Int J Case Rep Images

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Introduction: Neck veins are increasingly used in autologous tissue transfers, diagnostic procedures, and intravenous therapies. Thus, knowledge of variation in their anatomy is of huge clinical importance in modern medicine. There have been several case reports of variation in the external jugular vein (EJV) anatomy, but fenestration remains one of the rarest anomalies reported. Case Report: During dissection of an embalmed 80-year-old male cadaver, unilateral (left-sided) fenestration of the EJV was noted. Shortly after the union of the retromandibular and posterior auricular veins, the EJV bifurcated, forming medial and lateral divisions. These descended superficially to sternocleidomastoid muscle before reuniting inferior to its posterior border in the posterior triangle of the neck and draining into the subclavian vein. No structures passed through the fenestration. A review of existing literature found five reports of unilateral EJV fenestration. Of note, ours is the only case where the anomaly has occurred in a male. Conclusion: Fenestration of the EJV is a rare anatomical anomaly. This case report contributes to the limited body of evidence regarding the true incidence of this variant. Further research will be beneficial in building a more comprehensive

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“…On the other hand, recent studies, including a systematic review, showed no significant difference in the rate of thrombosis between the internal and external jugular veins. 4 , 5 After neck dissection, the external jugular vein is occasionally dissected extensively and seems unreliable as a recipient vein. However, in most cases, the internal jugular vein maintains its large diameter and rich blood flow.…”

Section: Discussionmentioning

confidence: 99%

Free Flap Survival Despite Internal Jugular Vein Thrombosis in Head and Neck Reconstruction

Kiya

Kubo

Seike

et al. 2018

Plastic and Reconstructive Surgery - Global Open

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Summary:Microvascular free tissue transfer is one of the most common techniques of reconstruction for complex head and neck surgical defects. Generally, venous thrombosis is more likely to occur than arterial thrombosis in vascular anastomosis. Thus, recipient veins must be chosen carefully. Although the internal jugular vein is preferred as a recipient vein by many microsurgeons, internal jugular vein thrombosis is a potential complication, as shown in our report. Therefore, we consider that the external jugular vein still is an option as a recipient for venous anastomosis and that it is better to perform multiple vein anastomoses with 2 different venous systems, such as the internal and external jugular systems, than anastomoses within the same venous system.

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External or Internal Jugular Vein? Recipient Vein Selection in Head and Neck Free Tissue Transfer

Cited by 21 publications

References 5 publications

Controversies in free tissue transfer for head and neck cancer: A review of the literature

Controversies in free tissue transfer for head and neck cancer: A review of the literature

A case of unilateral fenestration of the external jugular vein in a male cadaver with a review of existing literature

Free Flap Survival Despite Internal Jugular Vein Thrombosis in Head and Neck Reconstruction

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