title: Changes in the jugular bulb associated with sacrifice of the internal jugular vein.
abstract: OBJECTIVE
  To determine whether sacrifice of the internal jugular vein (IJV) causes subsequent changes in the jugular bulb.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Patients were selected by CPT code for neck dissection and were included in the study if they had undergone unilateral neck dissection and had preoperative and postoperative computed tomographic scans through the temporal bone.
  
  
  METHODS
  The jugular bulb was measured in the axial plane for anteroposterior and mediolateral diameters.
  
  
  METHODS
  Cross-sectional area of the jugular bulb was calculated, and comparison was made between preoperative and postoperative studies in patients with or without ligation of the IJV.
  
  
  RESULTS
  After unilateral neck dissection, the mean change in the size of the jugular bulb ipsilateral to surgery with sacrifice of the IJV was found to be -10.4 mm (95% confidence interval [95% CI], ± 8.54 mm); ipsilateral to surgery without sacrifice of the internal jugular, -0.2 mm (95% CI, ± 3.24 mm); contralateral to surgery with sacrifice of the IJV, +1.9 mm (95% CI, ± 11.12 mm); and contralateral to surgery without sacrifice of the IJVa, +1.0 mm (95% CI, ± 2.66 mm). Analysis of variance demonstrated a significant difference for changes in the jugular bulb area ipsilateral to surgery with sacrifice of the IJV (p = 0.03) when compared with contralateral to surgery without sacrifice of the IJV.
  
  
  CONCLUSIONS
  Changes in size of the jugular bulb occur with surgical manipulation of the jugular vein. This study demonstrates a decrease in the size of the jugular bulb with ipsilateral IJV sacrifice.
authors.affiliation: *Departments of Otolaryngology and †Radiology, Boston University Medical Center; and ‡Boston University School of Medicine, Boston, Massachusetts, U.S.A.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Brook
authors.forename: Karen
authors.initials: K
authors.lastname: Buch
authors.forename: Dominick
authors.initials: D
authors.lastname: Gadaleta
authors.forename: Scharukh
authors.initials: S
authors.lastname: Jalisi
authors.forename: Gregory
authors.initials: G
authors.lastname: Grillone
authors.forename: Osamu
authors.initials: O
authors.lastname: Sakai
authors.forename: Avner
authors.initials: A
authors.lastname: Aliphas
mesh_terms: D003392:Cranial Sinuses / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects*; D011184:Postoperative Period; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed