Ruptured internal jugular vein: a postoperative complication of modified/selected neck dissection

Abstract

Background: Postoperative hemorrhage from the internal jugular vein after a modified or selective neck dissection is an infrequent, yet potentially life-threatening, complication. Despite the increasing frequency of modified or selective neck dissections, this complication has not been previously highlighted in the literature.

Setting: Tertiary referral academic center.

Material and methods: The records of six patients who experienced this complication were reviewed and analyzed for risk factors that might predict its occurrence.

Results: Common risk factors included postoperative pharyngeal fistula formation, significant tobacco history, and poor nutritional status. A more complete circumferential dissection of the vein low in the neck in the presence of hypopharyngeal fistula may place it at a higher risk for rupture.

Conclusions: Patients who have a complete circumferential dissection of the internal jugular vein low in the neck and go on to have fistulas develop may be more prone to internal jugular vein rupture.