BILATERAL RADICAL NECK DISSECTION WITH UNILATERAL INTERNAL JUGULAR-VEIN RECONSTRUCTION

Objective: To describe and evaluate the functional and oncologic resul ts of one internal jugular vein replacement after bilateral radical ne ck dissection (RND). Study Design: A retrospective historical cohort s tudy. Methods: Since 1972 all patients (n = 9) undergoing bilateral RN D with resection of both internal jugular veins had a reconstruction o f one internal jugular vein. In six cases the RNDs were staged, and in three cases the RNDs were performed simultaneously. In every case a v ascular reconstruction was performed with an autologous vein graft. Al l patients received radiation therapy, in five patients before and in four patients after the vein grafting. Functional results were evaluat ed in terms of postoperative head and neck and neurologic complication s. In some patients a Doppler scan was performed to assess vein patenc y. Oncologic results are reported as relapse-free survival and mortali ty intervals. Results: In all patients the postoperative course was un eventful, without neurologic complications. Facial edema was noted in four patients, mild in three and moderate in one. Two patients are ali ve, with follow-ups of 8 and 18 years. Seven patients are dead, two wi thout evidence of recurrence, four with cervical recurrence after a me an survival of 10 months, and one after distant metastasis after a sur vival of 7 years. In patients with long-term survival a Doppler scan c onfirmed the patency of the vein graft. Conclusion: The lack of operat ive complications and the absence of postoperative neurologic complica tions make a unilateral internal jugular vein replacement after bilate ral RND attractive, although the oncologic results remain poor.