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Ruptured internal jugular vein: a postoperative complication of modified/selected neck dissection
Suzanne S Cleland-Zamudio1, Mark K Wax, James D Smith
1Department of Otolaryngology/Head and Neck Surgery, Oregon Health Sciences University, Portland, OR 97201, USA.
Background:
Postoperative hemorrhage from the internal jugular vein after a modified or selective neck dissection is an infrequent, yet potentially life-threatening, complication. Despite the increasing frequency of modified or selective neck dissections, this complication has not been previously highlighted in the literature.
Setting:
Tertiary referral academic center.
Material And Methods:
The records of six patients who experienced this complication were reviewed and analyzed for risk factors that might predict its occurrence.
Results:
Common risk factors included postoperative pharyngeal fistula formation, significant tobacco history, and poor nutritional status. A more complete circumferential dissection of the vein low in the neck in the presence of hypopharyngeal fistula may place it at a higher risk for rupture.
Conclusions:
Patients who have a complete circumferential dissection of the internal jugular vein low in the neck and go on to have fistulas develop may be more prone to internal jugular vein rupture.