Internal jugular vein reconstruction in bilateral radical neck dissection

Abstract

(Editorial Comment: The authors emphasize the potential importance of jugular vein reconstruction in patients with advanced bilateral cervical metastasis in whom a bilateral radical neck dissection obviates potential for preservation of a single jugular vein.) Simultaneous bilateral modified neck dissections are well tolerated by head and neck cancer patients and the use of dissections in the management of palpable and occult metastatic disease of the upper aerodigestive tract is increasingaIm The low morbidity associated with these procedures is secondary to the ability to preserve important structures such as the internal jugular vein (IJV), spinal accessory nerve, and the sternocleidomastoid mus-cle.4 Maintenance of at least one internal jug- jugular vein in these bilateral lymphadenectomies is helpful in reducing the complicationsof interrupting the venous drainage of the head. Massive postoperative head and neck edema,4-” increased intracranial pressure,7 orsure, or syndrome of inappropriate antidiuretic hor-mone secretion (SIADH)’ may occur if both IJVs are surgically occluded5- despite the presence of collateral venous drainage. Severe intracranial sequelae such as stroke, blindness,g and even death7 have been reported [Table