Internal Jugular Vein Patency and Methods of Reconstruction after Neck Dissection in Patients with Oral Cancer:

Makiguchi, Takaya

Internal Jugular Vein Patency and Methods of Reconstruction after Neck Dissection in Patients with Oral Cancer:

Takaya Makiguchi PhD, Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan

Satoshi Yokoo , Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan

Masaru Ogawa , Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan

Hidetaka Miyazaki , Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan

Atsushi Musha , Gunma University Heavy Ion Medical Center, Maebashi, Japan

Stenosis and obstruction of the internal jugular vein (IJV) sometimes occur following modified radical neck dissection or selective neck dissection, in which the IJV is preserved. The objective of this study was to assess risk factors for stenosis or obstruction of the IJV following neck dissection.

A total of 58 neck dissections performed in 51 patients by the same surgeon at Gunma University Hospital were retrospectively reviewed. The relationships of the patency of the IJV with gender, side of dissection, number of lymph node metastases, invasion out of the lymph node, radiotherapy, and reconstructive method were examined. The patency of the IJV was evaluated postoperatively using enhanced computed tomography.

All cases with obstruction of IJV received postoperative radiotherapy and neck dissection on the left side. Postoperative radiotherapy was a significant risk factor for obstruction of the IJV. Free flap reconstruction was not a risk factor for stenosis and obstruction. The rate of obstruction of the IJV was significantly decreased in cases with pectoral major musculocutaneous flap reconstruction or supraomohyoid neck dissection in which the muscle extensively covered the IJV.