Selection strategy of recipient blood vessel during secondary free reconstruction in head and neck surgery: experiences over ten years

doi:10.19438/j.cjoms.2020.05.015

Abstract

Abstract: PURPOSE: To summarize the selection strategy of recipient blood vessel during secondary free reconstruction in head and neck surgery. METHODS: Between September 2009 and September 2019, 22 cases of secondary reconstruction of head and neck defects with free flaps were retrospectively analyzed, and relevant clinical data such as recipient blood vessels, anatomical time and distance between anastomosis area and defect area were summarized. RESULTS: Of the 22 cases, 19 underwent harvesting of ipsilateral neck blood vessels in the recipient region, including 13 transverse cervical vessels, 3 superficial temporal vessels, 2 superior thyroid artery and internal jugular vein, 1 facial artery and internal and external jugular vein; 3 patients underwent harvesting of contralateral neck blood vessels in the recipient region, including 2 from facial artery and internal jugular vein, 1 from facial artery and internal and external jugular vein. All flaps survived without obvious complications. COUCLUSIONS: Transverse cervical vessels or superficial temporal vessels should be the first choice for the recipient vessels during secondary free flap reconstruction after head and neck surgery. If neither is possible, the unoperated contralateral neck can be opened to find the ideal recipient vessels. When no blood vessels are available after neck dissection and/or radiotherapy of contralateral neck, the ipsilateral neck blood vessels with good quality should be carefully explored for anastomosis. Cephalic vein transposition, vein transplantation, intramammary vessels or pectoral acromial vessels may be used as the last resort.

Key words: Vessel depleted neck, Free flap, Microsurgical reconstruction, Transverse cervical vessel, Superficial temporal vessel

CLC Number:

R782.05

XU Qiang, WANG Si-min, LIU Yi-hao, YIN Shou-cheng, SU Xing-zhou, XU Zhong-fei. Selection strategy of recipient blood vessel during secondary free reconstruction in head and neck surgery: experiences over ten years[J]. China Journal of Oral and Maxillofacial Surgery, 2020, 18(5): 457-464.

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