title: Factors influencing internal jugular vein patency after neck dissection in oral cancer.
abstract: The objective was to investigate factors influencing internal jugular vein stenosis or occlusion after neck dissection, including the reconstructive procedure. The subjects were 73 patients (81 veins) who underwent a modified radical neck dissection, in which the internal jugular vein was preserved, or an extended supraomohyoid neck dissection (E-SOHND). All procedures were performed by the same surgeon. Internal jugular vein patency was evaluated by contrast-enhanced computed tomography. Patency was evaluated in relation to gender, side of dissection, number of pathological lymph node metastases, extracapsular spread of lymph node metastases, radiotherapy, and the reconstruction method (no reconstruction, free flap, or pedicle flap). All internal jugular vein occlusions were on the left side and all except one of these patients underwent radiotherapy. Thus, radiotherapy and left side dissection were significant risk factors for occlusion. Free flap reconstruction was not a risk factor for vein stenosis or occlusion. Patients undergoing reconstruction with pedicled musculocutaneous flaps or E-SOHND were less likely to have vein occlusion. Particular care is required for left neck dissection in patients who have undergone radical neck dissection on the right side. This study suggests that covering the internal jugular vein with the muscle might prevent vein occlusion.
authors.affiliation: Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Gunma, Japan. Electronic address: takayamakiguchi@gmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Makiguchi
authors.affiliation: Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Gunma, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yokoo
authors.affiliation: Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Gunma, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ogawa
authors.affiliation: Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Gunma, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Miyazaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006801:Humans; D015994:Incidence; D007472:Iohexol; D007564:Japan / Q000453:epidemiology; D007601:Jugular Veins / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D037981:Neck Dissection; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D019651:Plastic Surgery Procedures; D012307:Risk Factors; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D014654:Vascular Patency; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000453:epidemiology
chemical_list: D003287:Contrast Media; D007472:Iohexol
keywords: internal jugular vein; neck dissection; reconstruction; stenosis and obstruction; thrombosis