ABSTRACT Background The risk of internal jugular vein thrombosis is a concern when using the internal jugular vein as a recipient vein in microvascular head and neck reconstruction. This study aimed to investigate the incidence of internal jugular vein thrombosis within 2 weeks of microvascular head and neck reconstruction using computed tomographic angiography. Methods This retrospective study included 103 patients who underwent postoperative contrast‐enhanced computed tomography within 2 weeks of microvascular head and neck reconstruction. The incidence, characteristics, treatment course, outcomes, and risk factors of internal jugular vein thrombosis were investigated. Results Internal jugular vein thrombosis was found in five cases (4.7%). In three of these cases (2.8%), internal jugular vein thrombosis occurred on the side of the microvascular anastomosis, and all of them were completely obstructed; however, the flaps survived without vascular compromise. No variables were considered risk factors for internal jugular vein thrombosis. Conclusions The incidence of internal jugular vein thrombosis after microvascular head and neck reconstruction was lower than previously reported. Most cases of internal jugular vein thrombosis are assumed to be subclinical and do not lead to anastomotic failure. It remains unclear whether asymptomatic internal jugular vein thrombosis on the anastomotic side should be treated. Level of Evidence 3.
Kurita et al. (Thu,) studied this question.