Daurade Mathieu, Céruse Philippe, Berania Ilyes, Philouze Pierre
Department of Maxillofacial Surgery, Croix Rousse Hospital, Lyon, France.
Department of Head and Neck Surgery, Croix Rousse Hospital, Lyon, France; University Claude Bernard Lyon 1, Lyon, France.
Int J Oral Maxillofac Surg. 2020 Dec;49(12):1545-1547. doi: 10.1016/j.ijom.2020.07.019. Epub 2020 Aug 6.
Head and neck surgery for advanced neck disease may require ablation of critical structures, including the internal jugular vein (IJV). Although unilateral ligation of the IJV is not commonly associated with a significant increase in morbidity, bilateral sacrifice of the internal venous system may cause severe complications. We present the case of a 60-year-old man with a T4N2cM0 tumour of the left and right hypopharynx. The evolution of the disease required a bilateral modified radical neck dissection and sacrifice of both IJVs. We describe a vein grafting technique for the IJV using the external jugular vein as a donor vessel. Postoperative computed tomography imaging confirmed adequate blood perfusion. This report describes two new and accessible surgical options for immediate IJV grafting. Although this modification slightly increases the surgery time and technical difficulty, it allows immediate restoration of venous perfusion, which may improve the prognosis and patient outcomes.
对于晚期颈部疾病的头颈外科手术可能需要切除包括颈内静脉（IJV）在内的关键结构。尽管单侧结扎颈内静脉通常不会显著增加发病率，但双侧牺牲颈内静脉系统可能会导致严重并发症。我们报告了一例60岁男性患者，患有左右下咽T4N2cM0肿瘤。疾病的进展需要进行双侧改良根治性颈清扫术并牺牲双侧颈内静脉。我们描述了一种使用颈外静脉作为供体血管进行颈内静脉血管移植的技术。术后计算机断层扫描成像证实了充足的血液灌注。本报告描述了两种新的且可行的即时颈内静脉移植手术选择。尽管这种改良会稍微增加手术时间和技术难度，但它能即时恢复静脉灌注，这可能改善预后和患者结局。
