Document Detail


Preservation of the external jugular venous drainage system in neck dissection.
MedLine Citation:
PMID:  19932846     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate whether preserving the external jugular vein (EJV) in neck dissection reduces postoperative edema of the face and neck. STUDY DESIGN: A prospective, randomized controlled trial. SETTING: A tertiary hospital. SUBJECTS AND METHODS: Thirty-eight subjects were randomly assigned to two groups: EJV preservation versus sacrifice during neck dissection after stratification according to the neck dissection extent and type, the previous treatment, the primary site, and the reconstruction type. The relative soft-tissue thickness was evaluated by follow-up computed tomography (CT) scans at one week and four to five weeks postoperatively and compared with preoperative findings. The preserved EJV patency was also determined by contrast enhancement of EJV on follow-up CT scans. In addition, the scores for pain/discomfort on the upper neck/face and laryngeal edema were recorded at each time point. RESULTS: Relative soft-tissue thickness reached up to 160 percent of preoperative status at the hyoid and cricoid levels at one week postoperatively but resolved at four to five weeks. EJV preservation reduced the soft-tissue thickness significantly compared with EJV sacrifice (P < 0.05) at one week postoperatively, particularly at the mandible and hyoid level. All preserved EJVs remained patent at one week, and 18 of 19 remained patent at four to five weeks. In addition, EJV preservation diminished the discomfort/pain of the upper neck/face compared with EJV sacrifice at one week (P = 0.036). The extent of laryngeal edema did not differ between the two groups. CONCLUSION: EJV preservation may reduce immediate postoperative neck edema and pain/discomfort related to neck dissection.
Authors:
Man Ki Chung; Jeesun Choi; Jae-Kwon Lee; Jong In Jeong; Won Yong Lee; Han-Sin Jeong
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-10-31
Journal Detail:
Title:  Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery     Volume:  141     ISSN:  1097-6817     ISO Abbreviation:  Otolaryngol Head Neck Surg     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508176     Medline TA:  Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  730-6     Citation Subset:  IM    
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Edema / prevention & control*
Female
Head and Neck Neoplasms / radiography,  surgery*
Humans
Jugular Veins* / surgery
Male
Middle Aged
Neck Dissection*
Postoperative Complications / prevention & control*
Prospective Studies
Reconstructive Surgical Procedures
Statistics, Nonparametric
Tomography, X-Ray Computed
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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