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Internal jugular vein patency after lateral neck dissection: a prospective study.

Johnny Cappiello1, Cesare Piazza, Marco Berlucchi

  • 1Department of Otolaryngology, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, Italy.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|September 18, 2002
PubMed
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Internal jugular vein (IJV) occlusion is rare after lateral neck dissection (LND), with no long-term occlusions observed. Immediate postoperative IJV flow alterations are common but typically resolve.

Area of Science:

  • Otolaryngology
  • Surgical Oncology
  • Vascular Surgery

Background:

  • Internal jugular vein (IJV) occlusion can occur after neck dissections, despite anatomical preservation.
  • Selective or modified radical neck dissections have reported IJV occlusion rates up to 30%.

Purpose of the Study:

  • To prospectively evaluate the patency of the IJV after selective lateral neck dissection (LND).
  • To assess the incidence and recovery of IJV patency and flow following LND in upper aerodigestive tract cancer patients.

Main Methods:

  • Prospective study of 34 patients undergoing LND for upper aerodigestive tract squamous cell carcinoma.
  • Preoperative and serial postoperative ultrasonography (US) assessments of IJV patency and flow at 1 week, 1 month, and 3 months.
  • Fisher test used to assess the impact of postoperative radiotherapy on IJV patency.

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Main Results:

  • No patient experienced wound infection, fistula, or signs of IJV occlusion during follow-up.
  • Immediate postoperative US showed altered flow in 50% of IJVs (23 reduced, 2 absent).
  • At 3 months, 90% of IJVs demonstrated normal flow; no long-term occlusion was observed. Postoperative radiotherapy did not significantly impact IJV patency (P=0.09).

Conclusions:

  • Long-term internal jugular vein occlusion following lateral neck dissection is exceedingly rare with minimal morbidity.
  • Immediate postoperative alterations in IJV flow are frequent but typically transient.
  • Selective LND appears to preserve IJV patency effectively in the long term.