The external jugular vein provides a long, free vessel that facilitates microsurgical
anastomosis in free tissue transfers of the head and neck. However, it is liable to
kink because of its length, which increases the risk of venous thrombosis.
1
,
2
Early in a conventional neck dissection the vein is identified and ligated near the
inferior pole of the parotid gland. When a microvascular free flap is to be used for
reconstruction, the entire external jugular vein is dissected and preserved with a
suture-ligation at the upper end. Because of the prolonged duration of ischaemia before
revascularisation, clots can form in its lumen and may be found at the time of anastomosis.
Even after revascularisation using an end-to-end anastomosis, the decreased venous
flow may accelerate venous thrombosis.
3
We describe an end-to-side anastomosis to the external jugular vein that preserves
blood flow by avoiding ligation and decreases the likelihood of thrombosis.Keywords
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References
- Venous thrombosis after microvascular free-tissue transfer in head and neck cancer reconstruction.Auris Nasus Larynx. 2008; 35: 390-396
- Internal jugular vein versus external jugular vein anastomosis: implications for successful free tissue transfer.Head Neck. 2001; 23: 475-478
- Thrombophlebitis.Angiology. 1977; 28: 228-234
- Anatomy for surgeons. Vol. I: The head and neck.2nd ed. Harper & Row, New York1968
Article info
Publication history
Published online: August 26, 2011
Accepted:
July 12,
2011
Identification
Copyright
© 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
