Internal jugular vein thrombosis and pulmonary thromboembolism after head and neck reconstructive surgery

Kitano, Daiki; Yonezawa, Koichiro; Iwae, Shigemichi; Sakakibara, Shunsuke

doi:10.1016/j.bjps.2020.11.007

Cited by 4 publications

(3 citation statements)

References 36 publications

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“…A total of 146 studies were ultimately included in our meta‐analysis 9,24–167 . A PRISMA diagram outlining our search is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Vascular events in patients with head and neck cancer: A systematic review and meta‐analysis

Monaghan,

Duckett,

Nguyen

et al. 2024

Head & Neck

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ObjectiveTo assess the incidence of vascular events in patients with head and neck cancer.Review MethodsPrimary studies identified through April 2023. Meta‐analysis was performed.ResultsThere were 146 studies included in the systematic review. Rates of events were collected in the overall group, those with chemoprophylaxis, and those that underwent surgery, radiation, or chemotherapy. Of 1 184 160 patients, 4.3% had a vascular event. Radiation therapy had highest risk of overall events and stroke when compared to surgery and chemotherapy. Chemotherapy had a higher risk of stroke and overall events when compared to surgery.ConclusionsVascular events occur in 4%–5% of patients with head and neck cancer. Our data does not support the use of routine anticoagulation. Patients undergoing radiation therapy had the highest frequency of events.

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“…A total of 146 studies were ultimately included in our meta‐analysis 9,24–167 . A PRISMA diagram outlining our search is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Vascular events in patients with head and neck cancer: A systematic review and meta‐analysis

Monaghan,

Duckett,

Nguyen

et al. 2024

Head & Neck

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“…The recipient vein drains the blood from the flap, affecting the outcome of the procedure, as poor venous drainage will cause cyanosis, hypertonicity, or necrosis of the flap. 14 Veins larger than 1.5 mm are safe for free tissue flap 15 ; an anastomotic coupler could be used from 1.5 mm. 16 Therefore, the MTV is qualified as an alternative recipient vessel for free tissue flap, which has been confirmed in several surgical studies.…”

Section: Discussionmentioning

confidence: 99%

The Middle Temporal Vein on Computed Tomographic Angiography: Implications for Filler Injection and Reconstructive Surgery

Wang

Xiong

Zeng

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Detailed knowledge of middle temporal vein (MTV) anatomy would benefit health care professionals when performing filler injection and reconstructive surgery. The purpose of this study was to assess the variation and course of the MTV using computed tomographic angiography. Methods: Computed tomographic angiography images of 300 MTVs from 150 Asian patients were evaluated in this study. The course and branching pattern of the MTVs were evaluated, as well as the relationship between the location of the MTV and the frontal branch of the superficial temporal artery. The diameter of the MTV and the distances between anatomic landmarks and temporal vessels were measured. Results: The MTV was identified in all images, with an average diameter of 2.98 ± 0.80 mm. All MTVs had at least one major trunk; 12.3% had two major trunks. According to the landmarks, the MTV ran 16.3 ± 8.1 mm, 24.8 ± 4.5 mm, and 24.2 ± 4.6 mm above bony lateral canthus, jugale, and zygion point, respectively. Regarding the relationship between the MTV and the frontal branch of the superficial temporal artery, most of the superficial temporal arteries (81.7%) were located above the MTVs, whereas only 9.0% of the superficial temporal arteries crossed the MTVs. The superficial temporal artery was located 43.5 ± 9.6 mm, 44.3 ± 11.9 mm, and 37.0 ± 11.9 mm above the bony lateral canthus, jugale, and zygion point, respectively. Conclusion: Detailed knowledge of MTV anatomy will provide a valuable reference for safe filler injection and reconstructive surgery in the temporal region. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

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“…Early free flap failure may primarily be due to veinous thrombosis (usually within 72 h). Arterial thrombosis can occur even earlier and can be severe ( 60 ). Prolonged ischemia time during surgery and revision of microvascular anastomosis are risk factors for flap failure ( 61 , 62 ).…”

Section: Flap Changes and Their Clinical And Radiological Assessmentmentioning

confidence: 99%

Reconstructive flap surgery in head and neck cancer patients: an interdisciplinary view of the challenges encountered by radiation oncologists in postoperative radiotherapy

Thariat,

Carsuzaa,

Beddok

et al. 2024

Front. Oncol.

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BackgroundMajor advances have been made in reconstructive surgery in the last decades to reduce morbidity in head and neck cancer. Flaps are now present in 80% of patients with oral cavity cancer to cover anatomic, functional, and cosmetic needs. However, gaps in interdisciplinary innovation transfer from surgery to postoperative radiotherapy (poRT) remain challenging. We aimed to provide an interdisciplinary view of the challenges encountered by radiation oncologists in planning head and neck postoperative radiotherapy.MethodsA systematic and critical review was conducted to address areas of optimization in surgery and radiology that may be relevant to poRT.ResultsDespite extensive surgical literature on flap techniques and salvage surgery, 13 retrospective series were identified, where flap outcomes were indirectly compared between surgery alone or poRT. These low-evidence studies suggest that radiotherapy accelerates flap atrophy, fibrosis, and osteoradionecrosis and deteriorates functional outcomes. Preliminary evidence suggests that tumor spread occurs at the flap–tissue junction rather than in the flaps. One prospective 15-patient study showed 31.3% vs. 39.2% flap volume reduction without or with poRT. In an international consensus, experts recognized the needs for optimized flap-sparing poRT against flap-related functional deterioration and bone damage. CT, MRI, and PET-CT modalities show potential for the delineation of the junction area between native tissues and flap for flap segmentation and to characterize flap-specific changes quantitatively and correlate them with patterns of relapse or complications.ConclusionFlap management in poRT is insufficiently documented, but poRT seems to damage flaps. Current gaps in knowledge underscore the need for prospective flap assessment and interdisciplinary trials investigating flap morbidity minimization by flap-sparing poRT planning.

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Internal jugular vein thrombosis and pulmonary thromboembolism after head and neck reconstructive surgery

Cited by 4 publications

References 36 publications

Vascular events in patients with head and neck cancer: A systematic review and meta‐analysis

Vascular events in patients with head and neck cancer: A systematic review and meta‐analysis

The Middle Temporal Vein on Computed Tomographic Angiography: Implications for Filler Injection and Reconstructive Surgery

Reconstructive flap surgery in head and neck cancer patients: an interdisciplinary view of the challenges encountered by radiation oncologists in postoperative radiotherapy

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