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Internal jugular vein blowout complicating head and neck surgery

Published online by Cambridge University Press:  29 June 2007

Conrad V. I. Timon*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, The Toronto Hospital, Toronto General Hospital Division, Toronto, Ontario, Canada.
Dale Brown
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, The Toronto Hospital, Toronto General Hospital Division, Toronto, Ontario, Canada.
Patrick Gullane
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, The Toronto Hospital, Toronto General Hospital Division, Toronto, Ontario, Canada.
*
Conrad V. I. Timon, Department of Otolaryngology/Head and Neck Surgery, St James's Hospital, St James's Street, Dublin 8, Ireland.

Abstract

Internal jugular venous rupture after head and neck surgery is a rare but important condition to recognize. The Toronto General Hospital experience of this condition, together with its identification and management is reported.

Jugular vein rupture should be considered in patients undergoing primary tumour excision with modified or functional neck dissection complicated by a pharyngo-cutaneous fistula. Typically, bleeding is venous and occurs repeatedly. However, haemorrhage may be substantial and life-threatening. Treatment requires exploration and ligation of the venous system. The carotid artery should be assessed and protected at surgery, since there is a likelihood of a carotid blowout as the conditions have a common aetiology. It is important to distinguish jugular vein haemorrhage from carotid arterial rupture, since the former has a far better outcome if treated properly.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1994

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References

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