"In this report, Professor Hu explains the importance of cerebral blood supply and venous drainage, as well as the clinical evaluation and surgical treatment of internal jugular vein stenosis or compression.
Professor Hu and his team have conducted clinical research into internal jugular vein outflow disorders, including decompression procedures for selected patients whose jugular veins are compressed by surrounding anatomical structures. Surgery is not appropriate for every patient and requires careful assessment of symptoms, imaging and venous blood flow".
Thank you for that link, @Emerald! I’ll put Prof. Hu on our Doctors List as a doctor who knows about ES. We haven’t had very many members from China but at least now we have a doctor to refer any future Chinese members to.
@Isaiah_40_31@Jules Probably Professor Zhiqiang Hu doesn’t need being recommended in China as he and his team have apparently performed over 1000 internal jugular vein decompression surgeries since 2020! But he is apparently accepting international patients now. Here is a link for anyone who is interested.
Dr. Hu and his team don’t do 1000 surges. To date, we have completed 88 IJV decompression surgeries (88 patient), making ours the largest clinical center for such cases worldwide. They also plan to surgery on another 107 patients by 2029 (Clinical Trial NCT07560280 Evaluation Criteria, Diagnostic Criteria, Surgical Indications, and Establishment of Surgical Standards for “Cerebral Tinnitus Syndrome” Caused by Internal Jugular Vein Stenosis.). Where did you see 1000 proper patients??
Thank you for verifying that info @Emerald , that’s a massive number of surgeries! You’re so thorough with your research, we’re very grateful to have you here
Hi @Bmmac. This 30 minute perfusion technique is interesting.
You often hear of surgeons releasing the internal jugular vein by cutting into the carotid sheath but they don’t talk openly about this perfusion technique.
I found 2 recent publications that mention this perfusion technique as well. The publication that I created a post for a few days ago which descibes it in the surgical procedure and this one below :
Conclusions: In comparison to isolated osseous decompression, the combined surgical protocol, which incorporates partial atlas transverse process resection, release, andperfusion techniques, exhibits superior anatomical restoration, hemodynamic recovery, and symptom relief, while maintaining comparable safety profiles.
@Bmmac , we have had discussions about this, some of the US surgeons do we believe, but call this a fasciotomy instead, here’s a link: “Fasciotomy” - General - Living with Eagle @Luckee7 mentions freeing the carotid sheath in their post, & feeling weird sensations post-surgery:
[Floppy Jugular After Surgery - General - Living with Eagle]
(Floppy Jugular After Surgery)
So it does seem that Dr Nakaji certainly does this if needed…
Hi Jules
I had surgery with Nakaji and had the carotid sheath opened. It was not a 30 minute blood pressure increase with blood profusion as I read the procedure notes.
Maybe I am mistaken as I read both Chinese postings where they talk about increasing the blood pressure somewhat for 30 minutes. I don’t think that is a fasciotomy. ??
Ah right, I was focusing on the ‘release’ bit, I thought that was what you were asking about, my mistake… I don’t know if the perfusion is done routinely…
Jules from the procedures I have seen on you tube…Constantino and Lui there is no mention of perfusion…all interesting. Guessing it might provide better compliance by the vein to remain open???
I agree, @Bmmac. Perfusion is an interesting approach, sort of like a prolonged “ballooning” that holds the vein open for a period of time thus encouraging it to stay open permanently once the pressure is reduced.
That’s the way I look at it but they don’t really comment why. Adding another 30 minutes not something Docs want to do…I may ask Lui about it as I have consult with him coming up?
I’m guessing that it’s the time as you’ve said, that is quite a long time extra to have someone under for… Also maybe doctors are reluctant to increase someone’s blood pressure while under anesthetic for that time, it could be a bit of a risk perhaps?
But would be interesting to see if Dr Lui has read this research paper, and to ask his opinion!
