İnternal juguler ven akımı ve devamlılığının fonksiyonel boyun diseksiyonu sonrasında power dubleks Doppler ultrasonografi ile değerlendirilmesi

Amaç: Fonksiyonel boyun diseksiyonu sonrasında internal juguler ven kan akımının devamlılığı değerlendirildi.Hastalar ve Yöntemler: Ocak 2001 - Mart 2003 tarihleri arasında Haseki Eğitim ve Araştırma Hastanesi Kulak Burun Boğaz Kliniğinde; larenks, hipofarenks ve intraoral kavitenin tümörleri nedeniyle ameliyat edilen 25 hasta 6 kadın, 19 erkek; ort. yaş 53.9 yıl; dağılım 30-71 yıl çalışmaya dahil edildi. Kırk iki fonksiyonel boyun diseksiyonu sonrasında, internal juguler venler değerlendirildi. Power dubleks Doppler ultrasonografi ile; juguler ven kan akımı, trombüs varlığı veya yokluğu, ven çapı ve kan akım hızı değerlendirildi.Bulgular: Çalışmamızda internal juguler ven devamlılığı %95.2 olarak bulundu ve tromboz sadece iki hastada saptandı. Kan akım hızının, trombüs saptanan hastalarda, trombüs saptanmayan hastalardan anlamlı derecede daha düşük olduğu görüldü Sonuç: Fonksiyonel boyun diseksiyonu sonrasında, hastaların büyük kısmında internal juguler ven kan akımının devamlılığının sağlandığı görüldü

Assessment of internal jugular vein flow and patency with power duplex Doppler ultrasonography after functional neck dissection

Objectives: The purpose of this study was to assess the patency of the internal jugular vein after functional neck dissection. Patients and Methods: Twenty-five patients 6 females, 19 males; mean age 53.9 years; range 30 to 71 years who were operated on because of larynx, hypopharynx and intraoral cavity tumors in the Ear, Nose and Throat Clinic of Haseki Training and Research Hospital between January 2001 and March 2003 were included in the study. Internal jugular veins were evaluated after 42 functional neck dissections. By means of power duplex Doppler ultrasonography, the jugular blood flow, presence or absence of a thrombus, diameter of the vein, velocity of the blood flow were evaluated. Results: In our study the internal jugular vein patency rate was found to be 95.2%, and thrombosis was detected only in two patients. Blood flow velocity in patients with thrombus was found to be significantly lower than that observed in patients without thrombus p<0.05 . Conclusion: It was observed that blood flow of the internal jugular vein was ensured in most patients after functional neck dissection.

___

  • Crile G. Excision of cancer of the head and neck with special reference to the plan of dissection base of one hundred and thirty-two operations. JAMA 1906; 47:1780-6.
  • Beahrs OH, Gossel JD, Hollinshead WH. Technic and surgical anatomy of radical neck dissection. Am J Surg 1955;90:490-516.
  • Suárez O. El problema de las metástasis linfáticas y alejadas del cáncer de laringe e hipofaringe. Rec Otorrinolaringol (Chile) 1963;23:83-9.
  • Bocca E, Pignataro O. A conservation technique in radical neck dissection. Ann Otol Rhinol Laryngol 1967;76:975-87.
  • Gavilán J, Gavilán C, Herranz J. Functional neck dis- section: three decades of controversy. Ann Otol Rhinol Laryngol 1992;101:339-41.
  • Gavilán C, Gavilán J. Five-year results of function- al neck dissection for cancer of the larynx. Arch Otolaryngol Head Neck Surg 1989;115:1193-6.
  • Bocca E, Pignataro O, Oldini C, Cappa C. Functional neck dissection: an evaluation and review of 843 cases. Laryngoscope 1984;94:942-5.
  • Nagata T, Matsunaga K, Kawazu T, Kawano S, Oobu K, Ohishi M. Patency assessment of the internal jugular vein after neck dissection. Int J Oral Maxillofac Surg 2006;35:416-20.
  • de Bree R, van den Berg FG, van Schaik C, Beerens AJ, Manoliu RA, Castelijns JA, et al. Assessment of paten- cy of the internal jugular vein following neck dissec- tion and microvascular flap reconstruction by power Doppler ultrasound. J Laryngol Otol 2002;116:622-6.
  • Fisher CB, Mattox DE, Zinreich JS. Patency of the internal jugular vein after functional neck dissection. Laryngoscope 1988;98:923-7.
  • Thankappan K. Microvascular free tissue transfer after prior radiotherapy in head and neck reconstruction - A review. Surg Oncol 2009. [Epub ahead of print]
  • Arslan N, Dursun E, Oğuz B, Oğuz H, Safak MA, Demirci M, et al. Internal jugular vein thrombosis following functional and selective neck dissections. [Article in Turkish] Kulak Burun Bogaz Ihtis Derg 2008;18:355-61.
  • Leontsinis TG, Currie AR, Mannell A. Internal jugular vein thrombosis following functional neck dissection. Laryngoscope 1995;105:169-74.
  • Köybaşıoğlu A, İleri F, Akçayöz N, Özdemir H, Uzluer N, Çakmakçı E, ve ark. Selektif boyun disseksiyonla- rında vena jugularis interna açıklığına etkisi. Kulak Burun Boğaz İhtisas Dergisi 1996;3: 545-8.
  • Bahar S, Selçuk A, Altın L, Özcan KM, Dere H. Fonksiyonel boyun diseksiyonu ve radyoterapi sonrası internal juguler ven fonksiyonlarının değerlendiril- mesi. KBB-Forum 2005;4:173-6.
  • Zohar Y, Strauss M, Sabo R, Sadov R, Sabo G, Lehman J. Internal jugular vein patency after functional neck dissection: venous duplex imaging. Ann Otol Rhinol Laryngol 1995;104:532-6.
  • Brown DH, Mulholland S, Yoo JH, Gullane PJ, Irish JC, Neligan P, et al. Internal jugular vein thrombosis following modified neck dissection: implications for head and neck flap reconstruction. Head Neck 1998; 20:169-74.
  • Lake GM 3rd, DiNardo LJ, Demeo JH. Performance of the internal jugular vein after functional neck dissec- tion. Otolaryngol Head Neck Surg 1994;111:201-4.
  • Forbes K, Stevenson AJ. The use of power Doppler ultrasound in the diagnosis of isolated deep venous thrombosis of the calf. Clin Radiol 1998;53:752-4.
  • Prim MP, de Diego JI, Fernández-Zubillaga A, García- Raya P, Madero R, Gavilán J. Patency and flow of the internal jugular vein after functional neck dissection. Laryngoscope 2000;110:47-50.
  • Yucel EA, Orhan KS, Guldiken Y, Aydin K, Simsek T, Erdamar B, et al. Evaluation of factors concerning the patency of the internal jugular vein after functional neck dissection. Eur Arch Otorhinolaryngol 2003; 260:35-8.