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Internal jugular vein thrombosis following functional neck dissection
T G Leontsinis1, A R Currie, A Mannell
1Department of Otolaryngology, University of the Witwatersrand, Johannesburg, South Africa.
The Laryngoscope
|February 1, 1995
Summary
Functional neck dissection can lead to internal jugular vein thrombosis, impacting future contralateral neck surgeries. This study investigated venous thrombosis frequency after neck dissection for upper aerodigestive tract cancers.
Area of Science:
- Oncology
- Vascular Surgery
- Head and Neck Surgery
Background:
- Functional neck dissection is a common surgical procedure for upper aerodigestive tract squamous carcinoma.
- Maintaining internal jugular vein patency is crucial for venous drainage and planning subsequent contralateral surgeries.
Purpose of the Study:
- To prospectively determine the frequency of venous thrombosis on the side of the neck dissection.
- To identify potential causes and implications of internal jugular vein occlusion post-functional neck dissection.
Main Methods:
- Prospective investigation of 25 patients undergoing 27 functional neck dissections.
- Retrograde venography performed within 1 month postoperatively to assess internal jugular vein status.
Main Results:
- Ipsilateral internal jugular vein occlusion was demonstrated in 8 out of 19 patent veins post-dissection.
- Venous thrombosis occurred in 5 patients following major wound sepsis or fistula formation.
- Three cases of spontaneous internal jugular vein thrombosis were identified with no clear cause.
Conclusions:
- Functional neck dissection does not guarantee internal jugular vein patency.
- Potential mechanisms for spontaneous thrombosis include endothelial trauma, reduced venous flow, and altered coagulability.
- Unexpected ipsilateral internal jugular vein occlusion has significant implications for planning contralateral neck dissections and managing patient outcomes.