Internal jugular vein rupture after oncologic resections in the head and neck

Abstract

Abstract Background Internal jugular vein (IJV) blowout after major oncologic resections in the head and neck is a rare fatal yet preventable complication. The condition is unregistered sufficiently in the literature. Results The records of patients who underwent oncologic neck surgery were retrospectively reviewed. The study included records between January 2014 and November 2019 at Kasr Al Ainy Educational Hospital. 275 patients underwent cervical ablative procedures. Ten patients developed IJV blowout. Six patients were saved. Four patients had diabetes mellitus with postoperative wound infection and dehiscence. Three patients were given primary radiotherapy; two of them developed flap necrosis. Eight patients acquired pharyngocutaneous fistula (PCF). Regional flap coverage was done in three patients. Sentinel hemorrhage occurred in all patients. Conclusions IJV blowout is a rare potentially life-threatening complication usually preceded by sentinel hemorrhage. The condition is essentially preventable by the prompt and structured response.