External Jugular Venous Thrombosis After Head and Neck Reconstruction: Report of Two Cases

Abstract

 The usefulness of free flaps in head and neck reconstructions has become widely recognized in recent years. Moreover, high survival rates have been reported with their use. Herein, we report two cases of external jugular venous thrombosis that occurred at our institution. In these cases, an anterolateral thigh flap reconstruction was performed after tumor resection and neck dissection. In Case 1, the drain compressed the external jugular vein, leading to thrombosis. In Case 2, excessive dissection of the external jugular vein during the neck dissection caused vessel twisting and breakage, which may have contributed to thrombus formation. It is necessary to devise drain placement and fixation methods tailored to the extent of loss of the surrounding tissue to reduce vessel damage. Moreover, recipient vessel selection and venous anastomosis quantity should be carefully considered.