Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015:2015:168474.
doi: 10.1155/2015/168474. Epub 2015 Jan 6.

Preservation of the external jugular vein in bilateral radical neck dissections: technique in two cases and review of the literature

Rodrigo Lima Bastos da Rocha  1 , André Del Negro  2 , Alfio José Tincani  2 , Maíra Soliani Del Negro  3 , Antonio Santos Martins  2
Affiliations

Preservation of the external jugular vein in bilateral radical neck dissections: technique in two cases and review of the literature

Rodrigo Lima Bastos da Rocha et al. Case Rep Med. 2015.

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Left radical neck dissection with preservation of the left external jugular vein (EJV).
Figure 2
Figure 2
Postoperative duplex scan of case #1 showing patent left external jugular vein (EJV), collateral veins (C), and common carotid artery (CCA).
Figure 3
Figure 3
Right modified neck dissection (preserving the right thyrolinguofacial trunk and the right IJV distal stump).
See this image and copyright information in PMC

References

    1. Crile G. Excision of cancer of the head and neck. Journal of the American Medical Association. 1989;47:1780–1786.
    1. Comerota A. J., Harwick R. D., White J. V. Jugular venous reconstruction: a technique to minimize morbidity of bilateral radical neck dissection. Journal of Vascular Surgery. 1986;3(2):322–329. doi: 10.1016/0741-5214(86)90017-0. - DOI - PubMed
    1. Weingarten C. Z. Simultaneous bilateral radical neck dissection. Preservation of the external jugular vein. Archives of Otolaryngology. 1973;97(4):309–311. doi: 10.1001/archotol.1973.00780010319004. - DOI - PubMed
    1. Leclerc G., Roy J. La resecction successive des deux jugulaire internes au cours des evidement ganglionnaires bilatereaus du cou. La Presse Médicale. 1932;40:1382–1383.
    1. Chung M. K., Choi J., Lee J.-K., Jeong J. I., Lee W. Y., Jeong H.-S. Preservation of the external jugular venous drainage system in neck dissection. Otolaryngology—Head & Neck Surgery. 2009;141(6):730–736. doi: 10.1016/j.otohns.2009.08.031. - DOI - PubMed

LinkOut - more resources