Patency assessment of the internal jugular vein after neck dissection.
Twenty-seven patients with oral malignant tumours, who underwent neck dissection with preservation of the internal jugular vein (IJV), were studied retrospectively to evaluate patency of the IJV. Twenty-three patients underwent ablative surgery of the primary lesion with neck dissection and 4 underwent neck dissection alone. Three patients received simple closure and skin grafting of the primary lesion, and 20 received reconstruction surgery (4 platysma flaps, 3 radial forearm flaps, 3 lateral upper arm flaps, 2 pectoralis major myocutaneous flaps and 8 rectus abdominis myocutaneous flaps). The maximum and minimum diameters of the IJV as measured on computed tomographic (CT) scans were used to assess patency. The cross-sectional area of the IJV and the ratio of its long axis to short axis (L/S ratio) were calculated. The relation between the change in IJV status and the type of flap used for reconstruction was also examined. Occlusion of the IJV was present in 3.7% of the patients, and 'narrowing' was present in 63.6%. The size of the flap significantly correlated with 'narrowing' of the IJV, suggesting that 'narrowing' was caused mainly by compression due to the flap.
Nagata
T
T
Department of Oral and Maxillofacial Surgery, Hamamatsu University School of Medicine, 1-20-1, Handa-yama, Hamamatsu City, Shizuoka, 431-3125 Hamamatsu, Japan. nagatez@hama-med.ac.jp
Matsunaga
K
K
Kawazu
T
T
Kawano
S
S
Oobu
K
K
Ohishi
M
M
D002294:Carcinoma, Squamous Cell / Q000601:surgery; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D008207:Lymphatic Metastasis; D008866:Microsurgery / Q000009:adverse effects; D009062:Mouth Neoplasms / Q000601:surgery; D037981:Neck Dissection / Q000009:adverse effects* / Q000379:methods; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000009:adverse effects*; D014654:Vascular Patency