Venous Collateral Blood Flow Assessed by Doppler Ultrasound after Unilateral Radical Neck Dissection

Removal of the internal jugular vein (IJV) in unilateral radical neck dissection (rND) necessitates redirection of cerebrovenous blood to collateral pathways. If adaptation is insufficient, neurologic sequelae develop that are due to impaired venous drainage and increased intracranial pressure. The...

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Bibliographic Details
Published in:Annals of otology, rhinology & laryngology rhinology & laryngology, 2001-11, Vol.110 (11), p.1055-1058
Main Authors: Doepp, Florian, Lammert, Ingeborg, Hoffmann, Olaf, Einhäupl, Karl Max, Schreiber, Stephan, Valdueza, José Manuel
Format: Article
Language:English
Subjects:
Biological and medical sciences
Blood Flow Velocity
Cerebrovascular Circulation
Collateral Circulation
Female
Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics
Hemodynamics
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Neck Dissection
Nervous system
Statistics, Nonparametric
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the upper aerodigestive tract
Ultrasonic investigative techniques
Ultrasonography, Doppler, Color
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Summary:Removal of the internal jugular vein (IJV) in unilateral radical neck dissection (rND) necessitates redirection of cerebrovenous blood to collateral pathways. If adaptation is insufficient, neurologic sequelae develop that are due to impaired venous drainage and increased intracranial pressure. The authors studied venous hemodynamic effects of unilateral rND using Doppler and duplex ultrasound in 17 patients. Blood flow velocities (BFVs) were recorded from the distal IJV (dIJV) and the vertebral vein (VV) before and 9 to 88 days after surgery. A preoperative compression test of the dIJV was performed to identify the side of dominant drainage. The BFV increased in the contralateral dIJV after right-sided rND (n = 10) by 111% (range, 50% to 320%), and after left-sided rND (n = 7) by 34% (range, 5% to 105%). In the contralateral VV, a rise of BFV by 75% was found. Our results confirm the role of the contralateral dIJV as the predominant collateral pathway. The VVs serve as an important additional major outflow. Doppler ultrasound may help to identify patients at risk of insufficient cerebrovenous drainage after rND.
ISSN:0003-4894
1943-572X
DOI:10.1177/000348940111001112