Bilateral radical neck dissection with unilateral internal jugular vein reconstruction.
OBJECTIVE
To describe and evaluate the functional and oncologic results of one internal jugular vein replacement after bilateral radical neck dissection (RND).


METHODS
A retrospective historical cohort study.


METHODS
Since 1972 all patients (n = 9) undergoing bilateral RND with resection of both internal jugular veins had a reconstruction of one internal jugular vein. In six cases the RNDs were staged, and in three cases the RNDs were performed simultaneously. In every case a vascular reconstruction was performed with an autologous vein graft. All patients received radiation therapy, in five patients before and in four patients after the vein grafting. Functional results were evaluated in terms of postoperative head and neck and neurologic complications. In some patients a Doppler scan was performed to assess vein patency. Oncologic results are reported as relapse-free survival and mortality intervals.


RESULTS
In all patients the postoperative course was uneventful, without neurologic complications. Facial edema was noted in four patients, mild in three and moderate in one. Two patients are alive, with follow-ups of 8 and 18 years. Seven patients are dead, two without evidence of recurrence, four with cervical recurrence after a mean survival of 10 months, and one after distant metastasis after a survival of 7 years. In patients with long-term survival a Doppler scan confirmed the patency of the vein graft.


CONCLUSIONS
The lack of operative complications and the absence of postoperative neurologic complications make a unilateral internal jugular vein replacement after bilateral RND attractive, although the oncologic results remain poor.
Dulguerov
P
P
Department of Otolaryngology-Head and Neck Surgery, Geneva University Hospital, Switzerland.
Soulier
C
C
Maurice
J
J
Faidutti
B
B
Allal
A S
AS
Lehmann
W
W
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D018572:Disease-Free Survival; D004487:Edema / Q000209:etiology; D005069:Evaluation Studies as Topic; D005145:Face; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D008207:Lymphatic Metastasis / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D015996:Survival Rate; D014182:Transplantation, Autologous; D018608:Ultrasonography, Doppler; D014654:Vascular Patency; D014680:Veins / Q000637:transplantation