Oncologic Surgery Department, Centre Léon Bérard, Lyon, France.
Vascular Medicine Department, Hôpital Privé Jean Mermoz, Lyon, France.
J Plast Reconstr Aesthet Surg. 2021 Sep;74(9):2042-2049. doi: 10.1016/j.bjps.2020.12.066. Epub 2020 Dec 27.
The consequences on the cervicofacial venous circulation of major cervicofacial vein ligations are poorly known. We aimed to highlight by using Doppler Ultrasound flow differences in the cervicofacial venous network in the case of unilateral or bilateral ligation of main venous collector trunks (external jugular vein [EJV] and internal jugular vein [IJV]) METHODS: A Doppler ultrasound was performed on 10 healthy volunteers, 8 patients with previous bilateral ligation of the EJV, 8 with a unilateral ligation of the EJV, and 8 with a unilateral ligation of the EJV and IJV, after modified radical neck dissection. The diameter, the flow direction and the peak systolic velocity (PSV) of the superficial temporal vein, the facial vein (FV) and the IJV were measured.
Healthy patients had a similar right and left PSV for all the veins studied, with always antegrade flows. Patients with previous ligations had some significant right/left differences and retrograde flows.
A redistribution of venous blood flow on the contralateral side of the face and neck seems to take place in the case of unilateral ligation of the EJV and/or IJV. Retrograde flows are sometimes observed in the case of previous ligation of the EJV and/or IJV and might compromise the success of venous microanastomoses.
主要颈静脉结扎对颈面部静脉循环的影响知之甚少。我们旨在通过在单侧或双侧结扎主要静脉收集干(颈外静脉[EJV]和颈内静脉[IJV])后,使用多普勒超声对颈面部静脉网络中的血流差异进行强调。
对 10 名健康志愿者、8 名 EJV 双侧结扎的患者、8 名 EJV 单侧结扎的患者和 8 名 EJV 和 IJV 单侧结扎的患者进行了多普勒超声检查。测量了颞浅静脉、面静脉(FV)和 IJV 的直径、血流方向和收缩期峰值速度(PSV)。
健康患者在所有研究的静脉中,右侧和左侧的 PSV 相似,血流均为前向。有结扎史的患者存在一些明显的右侧/左侧差异和逆行血流。
在 EJV 和/或 IJV 单侧结扎的情况下,面部和颈部对侧的静脉血流似乎重新分配。在 EJV 和/或 IJV 结扎史的情况下,有时会观察到逆行血流,这可能会影响静脉显微吻合的成功。