Bilateral radical neck dissection with immediate reconstruction of the internal jugular vein |
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| Affiliation: | 1. Department of Maxillofacial Surgery, Croix Rousse Hospital, Lyon, France;2. Department of Head and Neck Surgery, Croix Rousse Hospital, Lyon, France;3. University Claude Bernard Lyon 1, Lyon, France;4. Department of Head and Neck Surgery, Montreal University Hospital, Montreal, Canada;1. Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China;2. General Department, Hangzhou Dental Hospital, Hangzhou, China;3. Oral and Maxillofacial Department, Pyongyang Medical College, Kim Il Sung University, Pyongyang, Democratic People''s Republic of Korea;1. Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China;2. Department of Oral and Maxillofacial Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China;1. Chinese Academy of Medical Sciences, Peking Union Medical College, Plastic Surgery Hospital, Beijing, China;2. Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA;3. Division of Plastic and Reconstructive Surgery, Mayo Clinic Florida, Jacksonville, FL, USA;4. Department of Plastic Surgery, University of São Paulo, São Paulo, Brazil;1. State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases, and Department of Oral and Maxillofacial Surgery, School of Stomatology, the Fourth Military Medical University, Xi’an, China;2. State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi’an, China;1. Department of Maxillofacial Surgery, Erasmus MC – Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands;2. Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC – Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands;3. Department of Clinical Genetics, Erasmus MC – Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands;1. Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;2. Institute of Pathology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;3. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel;4. Department of Oral and Maxillofacial Surgery, Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel |
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| Abstract: | Head and neck surgery for advanced neck disease may require ablation of critical structures, including the internal jugular vein (IJV). Although unilateral ligation of the IJV is not commonly associated with a significant increase in morbidity, bilateral sacrifice of the internal venous system may cause severe complications. We present the case of a 60-year-old man with a T4N2cM0 tumour of the left and right hypopharynx. The evolution of the disease required a bilateral modified radical neck dissection and sacrifice of both IJVs. We describe a vein grafting technique for the IJV using the external jugular vein as a donor vessel. Postoperative computed tomography imaging confirmed adequate blood perfusion. This report describes two new and accessible surgical options for immediate IJV grafting. Although this modification slightly increases the surgery time and technical difficulty, it allows immediate restoration of venous perfusion, which may improve the prognosis and patient outcomes. |
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| Keywords: | Head and neck cancer Internal jugular vein Radical neck dissection Vein graft |
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