Abstract
When bilateral internal jugular veins are sacrificed in bilateral neck dissection, staged planned neck dissection or simultaneous reconstruction of the internal jugular vein is advocated. We treated a patient who underwent bilateral internal jugular vein resection with simultaneous unilateral internal jugular vein reconstruction and free jejunum transfer for pharyngoesophageal reconstruction in whom the flap vein anastomosed to the reconstructed jugular vein. The jejunal graft exhibited congestion immediately after removal of the vascular clamp. Therefore, we changed the recipient vein to the cephalic vein, and the graft survived. It is common for the unilateral internal jugular vein to be sacrificed, and it is also common for the flap vein of the free flap to be anastomosed to the preserved internal jugular vein in head and neck surgery. However, a unilateral reconstructed internal jugular vein after sacrificing bilateral internal jugular veins is different from preservation of the unilateral internal jugular vein. Anastomosing the flap vein of the free flap to a reconstructed unilateral jugular vein should be avoided except in specific conditions. The important factors are the diameter of the reconstructed vein and stump pressure of the internal jugular vein.
