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Advantages of internal jugular vein preservation in unilateral neck dissections

BACKGROUND: Facing the doubt about the existence or not of advantages in preserving the internal jugular vein (IJV) in unilateral neck dissections, the authors decided to determine if the patients with IJV ligation develop changes in retina examination that indicate an increasing in intracranial pressure, to evaluate the presence of neurologic changes and to verify the advantages on clinical and surgical outcome of the patients with IJV ligation. METHOD: This is a non-radomized, prospective study comprising 15 patients with head and neck squamous carcinoma treated at the Head and Neck Service of Hospital Heliópolis who were submitted to unilateral neck dissection as part of their treatment and divided in two groups: one with ligation of IJV and other with its preservation. All underwent to preoperative and postoperative retinography and clinical and neurological evaluation. RESULTS: Detectable ophthalmologic changes occurred in none of the two groups. The group with IJV ligation presented a larger incidence of neurologic complaints in postoperative period and a less favorable surgical outcome with a larger period of hospitalization due by local complications. CONCLUSIONS: Preservation of IJV in unilateral neck dissections took to a better postoperative outcome with less time of hospitalization even though no evidence of postoperative increasing in intracranial pressure was observed in patients with IJV ligation.

Radical neck dissection; Jugular veins; Benign intracranial hypertension


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