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Superior sagittal sinus thrombosis complicating neck dissection

Published online by Cambridge University Press:  19 March 2010

D J Howe ,
M J Henderson  and
I Ahmad
D J Howe*
Affiliation:
Department of ENT Surgery, Heart of England NHS Foundation Trust, Birmingham, UK
M J Henderson
Affiliation:
Department of ENT Surgery, Heart of England NHS Foundation Trust, Birmingham, UK
I Ahmad
Affiliation:
Department of ENT Surgery, Heart of England NHS Foundation Trust, Birmingham, UK
*
Address for correspondence: Mr David J Howe, The Granary, Hextall Old Farm, Hextall Lane, Ranton ST18 9GZ, UK. E-mail: [email protected]
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Abstract

Objective:

To report a superior sagittal sinus thrombosis occurring as a rare complication of neck dissection, and to present a review of published literature.

Case report:

A 42-year-old man underwent an elective neck dissection for a tumour stage 2, node stage 2b, tonsillar squamous cell carcinoma, prior to chemoradiotherapy. During surgery, the right internal jugular vein was sacrificed as part of the resection, as tumour was adherent to it. Two weeks after surgery, the patient was readmitted with seizures. Subsequent computed tomography and magnetic resonance venography confirmed a superior sagittal sinus thrombosis. The patient was subsequently anticoagulated and underwent radiotherapy without further complication. A review of pre-operative imaging indicated a dominant internal jugular vein, ligation of which may have been a factor in the subsequent sagittal sinus thrombosis.

Conclusion:

Superior sagittal sinus thrombosis following neck dissection is a rare occurrence, with little reported in the literature. Dominant internal jugular vein anatomy may be evident on pre-operative imaging. An awareness of this complication may be helpful to surgeons contemplating sacrifice of the internal jugular vein.

Keywords

Neck DissectionThrombosisSurgeryCancerSagittal Sinus
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 10 , October 2010 , pp. 1126 - 1128
Copyright
Copyright © JLO (1984) Limited 2010

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