Ruptured internal jugular vein: a postoperative complication of modified/selected neck dissection.
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.


METHODS
Tertiary referral academic center.


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.
Cleland-Zamudio
Suzanne S
SS
Department of Otolaryngology/Head and Neck Surgery, Oregon Health Sciences University, Portland, OR 97201, USA.
Wax
Mark K
MK
Smith
James D
JD
Cohen
James I
JI
D000368:Aged; D005260:Female; D006801:Humans; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects*; D010039:Otorhinolaryngologic Neoplasms / Q000601:surgery; D019106:Postoperative Hemorrhage / Q000209:etiology*; D012307:Risk Factors; D012422:Rupture, Spontaneous; D014652:Vascular Diseases / Q000209:etiology