title: Preservation of the external jugular vein in bilateral radical neck dissections: technique in two cases and review of the literature.
abstract: Context. The possibility of cephalic venous hypertension with the resultant facial edema and elevated cerebrospinal fluid pressure continues to challenge head and neck surgeons who perform bilateral radical neck dissections during simultaneous or staged procedures. Case Report. The staged procedure in patients who require bilateral neck dissections allows collateral venous drainage to develop, mainly through the internal and external vertebral plexuses, thereby minimizing the risks of deleterious consequences. Nevertheless, this procedure has disadvantages, such as a delay in definitive therapy, the need for a second hospitalization and anesthesia, and the risk of cutting lymphatic vessels and spreading viable cancer cells. In this paper, we discuss the rationale and feasibility of preserving the external jugular vein. Considering the limited number of similar reports in the literature, two cases in which this procedure was accomplished are described. The relevant anatomy and technique are reviewed and the patients' outcomes are discussed. Conclusion. Preservation of the EJV during bilateral neck dissections is technically feasible, fast, and safe, with clinically and radiologically demonstrated patency.
authors: General Surgery Service, Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), 13083-970 Campinas, SP, Brazil.
authors: Rodrigo Lima Bastos
authors: RL
authors: da Rocha
authors: Head and Neck Service, Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), 13083-970 Campinas, SP, Brazil.
authors: André
authors: A
authors: Del Negro
authors: Head and Neck Service, Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), 13083-970 Campinas, SP, Brazil.
authors: Alfio José
authors: AJ
authors: Tincani
authors: Anesthesiology Service, Department of Anesthesiology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), 13083-970 Campinas, SP, Brazil.
authors: Maíra Soliani
authors: MS
authors: Del Negro
authors: Head and Neck Service, Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), 13083-970 Campinas, SP, Brazil.
authors: Antonio Santos
authors: AS
authors: Martins
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