Harada Hiroyuki, Omura Ken, Takeuchi Yosuke
Oral Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
Auris Nasus Larynx. 2003 Aug;30(3):269-72. doi: 10.1016/s0385-8146(03)00053-1.
To determine the incidence of thrombosis and change in caliber of the internal jugular vein after neck dissection.
Between September 1999 and December 2000, we studied 68 patients who underwent 76 neck dissection that spared the internal jugular vein. Thrombosis of the internal jugular vein was determined using duplex Doppler scans. The examination was performed about 10 days after the operation. Preoperative and postoperative imaging was available for 28 patients who underwent 32 neck dissections after April 2000. These 28 patients were divided into three groups. Group 1 consisted of 5 internal jugular veins which were treated with supraomohyoid neck dissection. Group 2 included 17 internal jugular veins which were treated with functional neck dissection. For group 3, ten patients underwent simultaneous bilateral neck dissections that spared the ipsilateral internal jugular vein with concurrent contralateral radical neck dissection. For each group, the mean ratio of the post- to pre-operative caliber of the internal jugular vein was calculated. Measurements were planned for 7 days, 1 month, and 3 months postoperatively.
The overall patency of the 76 internal jugular veins after neck dissection was 100%. In all groups, the mean ratio of the post- to pre-operative caliber of the internal jugular vein was lowest during the early postoperative period, and gradually increased within 3 months after surgery.
The caliber of the internal jugular veins decreased the most during the early postoperative period; however, internal jugular vein thrombosis is uncommon.
确定颈清扫术后颈内静脉血栓形成的发生率及管径变化。
1999年9月至2000年12月期间,我们研究了68例行76次保留颈内静脉的颈清扫术的患者。采用双功多普勒扫描确定颈内静脉血栓形成情况。检查在术后约10天进行。2000年4月后行32次颈清扫术的28例患者有术前和术后影像学资料。这28例患者分为三组。第一组包括5条接受肩胛舌骨肌上颈清扫术的颈内静脉。第二组包括17条接受功能性颈清扫术的颈内静脉。第三组,10例患者同时行双侧颈清扫术,保留同侧颈内静脉,对侧行根治性颈清扫术。计算每组颈内静脉术后与术前管径的平均比值。计划在术后7天、1个月和3个月进行测量。
76条颈内静脉在颈清扫术后的总体通畅率为100%。在所有组中,颈内静脉术后与术前管径的平均比值在术后早期最低,并在术后3个月内逐渐增加。
颈内静脉管径在术后早期减小最为明显;然而,颈内静脉血栓形成并不常见。