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Complications of cervical, thoracic, and abdominal interventions for trauma
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
Adjacent structures that may be injured in the course of carotid dissection include major veins, nerves, and airway structures. As the incision is planned, it is important to understand the potential for incisional paresthesia from transection of cutaneous cervical nerves. For example, the greater auricular and transverse cervical nerves course along and then superior to the sternocleidomastoid muscles. While these are sensory nerves, traction or bruising may lead to hyperparesthesias. As the dissection continues deep to the platysma and sternocleidomastoid, the most prominent vein that runs adjacent to the carotid artery is the internal jugular vein. This is often involved with penetrating injuries given its relatively close position to the carotid artery. More typically injured as part of the dissection however is the facial vein and superior thyroid veins. These tributaries empty from medial to lateral where they enter the internal jugular vein, crossing over the carotid (Figure 33.1). The facial and superior thyroid veins are routinely ligated in order to better expose the carotid artery. Careful ligature of these vessels will prevent postoperative hematoma, as there is significant increase in venous pressure as the patients emerge from anesthesia and may cough or otherwise bear down. Additionally, care must be taken when encircling the facial vein to avoid injuring the hypoglossal nerve, and similarly when encircling the superior thyroid vein, not to injure the vagus nerve.
Surgical Anatomy of the Thyroid
Published in Madan Laxman Kapre, Thyroid Surgery, 2020
Ashutosh Mangalgiri, Deven Mahore
Usually, the thyroid gland is drained by the superior thyroid vein, the middle thyroid vein, and the inferior thyroid vein. The superior thyroid vein and the middle thyroid vein drain into the internal jugular vein. The inferior thyroid vein drains into the brachiocephalic vein. Often, a fourth vein is seen between the middle thyroid artery and the inferior thyroid vein. If it drains into the internal jugular vein, then it is called the fourth vein of Kocher (Figure 2.11).
Thyroid Microcirculation
Published in John H. Barker, Gary L. Anderson, Michael D. Menger, Clinically Applied Microcirculation Research, 2019
Linda J. Huffman, George A. Hedge
The venous efflux from the thyroid drains into bilateral superior, middle, or inferior thyroid veins.1,2 The superior thyroid veins lie in close proximity to the superior thyroid arteries and empty into the internal jugular vein. A middle thyroid vein may, or may not, be present, or may occur in parallel. These also empty into the internal jugular veins. The inferior thyroid veins often anastomose and form a venous plexus below the thyroid before emptying into the right or left brachiocephalic vein.
Single versus dual venous anastomosis in radial forearm free flaps in head and neck reconstruction
Published in Journal of Plastic Surgery and Hand Surgery, 2023
We also analyzed the relationship between venous compromise and recipient venous systems. The external jugular vein (EJV) system of the head and neck includes the anterior jugular vein and the EJV, while the internal jugular vein (IJV) system includes the tongue vein, the superior thyroid vein, the IJV, the anterior facial vein, the common facial vein and the concomitant venae of facial artery. When applying one vein anastomosis, the IJV system (N = 53) was more commonly used than the EJV system (N = 27). When two veins were used during the operation, attaching both the EJV and IJV systems was the most favored option (N = 161), followed by two IJV system veins (N = 10) and two EJV system veins (N = 2) (Figure 1). Venous compromise occurred the most when using one IJV system vein (N = 4, 7.5%), followed by one EJV system (N = 1, 3.7%), and both the EJV and IJV systems (N = 1, 0.6%). No venous compromise was observed when two IJV or EJV system veins were used. There was not a significant difference in the incidence of venous compromise between recipient venous systems (p=0.051).
A propensity score matching study between ultrasound-guided percutaneous microwave ablation and conventional thyroidectomy for benign thyroid nodules treatment
Published in International Journal of Hyperthermia, 2018
Hao Jin, Jinrui Fan, Kun Liao, Zhuocheng He, Wei Li, Min Cui
For conventional thyroidectomy, patients received general anesthesia with endotracheal intubation. After that they were placed in a supine position with their necks slightly extended. A 4–6 cm incision was made on the superior border of the sternum. Platysma myoides were abstracted to expose the TN. From the sternal notch to the level of the thyroid cartilage, subplatysmal flap dissection was conducted. The linea alba cervicalis was vertically divided from the strap muscles to expose the thyroid gland. The thyroid goiter was dissected with an ultrasound knife (Johnson&Johnson Inc., New Brunswick, NJ, USA). In the process of the operation, recurrent laryngeal nerves, superior thyroid arteries, inferior thyroid arteries, superior thyroid veins, inferior thyroid veins and middle thyroid veins should be carefully identified or transected. According to the TN’s location, volume and adjacent structures, the TN was cut off solely or accompanied with the other part of the thyroid gland lobes. Parathyroid glands were identified and the blood supply to parathyroid glands was protected carefully during the operation. The surgical field was douched with 100 ml sterile distilled water (37 °C). The surgical wound was sutured with a traumatic needle and 5–0 absorbable sutures.