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

da Rocha RL, Del Negro A, Tincani AJ, Del Negro MS, Martins AS - Case Rep Med (2015)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: General Surgery Service, Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), 13083-970 Campinas, SP, Brazil.

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.

No MeSH data available.


Related in: MedlinePlus

Left radical neck dissection with preservation of the left external jugular vein (EJV).
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Related In: Results  -  Collection


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fig1: Left radical neck dissection with preservation of the left external jugular vein (EJV).

Mentions: The pathologist's report indicated a grade II SCC, a microscopic positive surgical margin, no metastasis in 97 nodes examined, and one node with paracoccidioidomycosis. Postoperative radiotherapy was delayed because of local complications (mandible exposure and fistula). A needle biopsy done in the third month of follow-up revealed a 1 cm level I metastasis on the left side of the neck. The patient underwent a left radical neck dissection, with preservation of the EJV (Figure 1). This time, the pathologist's report showed three positive nodes (with extracapsular invasion) out of 21 examined.


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

da Rocha RL, Del Negro A, Tincani AJ, Del Negro MS, Martins AS - Case Rep Med (2015)

Left radical neck dissection with preservation of the left external jugular vein (EJV).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4302362&req=5

fig1: Left radical neck dissection with preservation of the left external jugular vein (EJV).
Mentions: The pathologist's report indicated a grade II SCC, a microscopic positive surgical margin, no metastasis in 97 nodes examined, and one node with paracoccidioidomycosis. Postoperative radiotherapy was delayed because of local complications (mandible exposure and fistula). A needle biopsy done in the third month of follow-up revealed a 1 cm level I metastasis on the left side of the neck. The patient underwent a left radical neck dissection, with preservation of the EJV (Figure 1). This time, the pathologist's report showed three positive nodes (with extracapsular invasion) out of 21 examined.

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: General Surgery Service, Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), 13083-970 Campinas, SP, Brazil.

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.

No MeSH data available.


Related in: MedlinePlus