Superficial Temporal Versus Cervical Recipient Vessels in Maxillary and Midface Free Vascularized Tissue Reconstruction: Our 14-Year Experience

Abstract

The aims of this study are to review our surgical experience in maxillary and midface reconstruction using free vascularized tissue and to compare the postoperative outcomes based on superficial temporal versus cervical recipient vessels. We performed a retrospective review of patients who underwent maxillary and midface reconstruction with free vascularized tissue from March 2001 to July 2014. Two groups were analyzed: those in whom superficial temporal vessels were used as the recipient vessels and those in whom cervical vessels were used as the recipient vessels. Patient gender and age, cause and classification of the defect, flap choice for reconstruction, recipient vessels, postoperative course, and complications also were recorded and analyzed. A 2-tailed Fisher exact test was used to compare outcomes between the 2 groups. On the basis of the different recipient vessels, 94 patients were divided into 2 groups: those with superficial temporal recipient vessels (n=44) and those with cervical recipient vessels (n=50). The overall flap survival rate was 99.0%. The overall complication rate for vascular anastomoses was 5.3%. The complication rate in patients with cervical recipient vessels was higher than the complication rate in those with superficial temporal recipient vessels (8.0% vs 2.27%, P=.37). In addition, in patients in the group with superficial temporal recipient vessels, the postoperative scar in the pre-tragal region was rated as more satisfactory than the postsurgical scar in those in the cervical recipient vessel group. We recommend that the superficial temporal vessels be the first option for recipient vessels in free vascularized tissue maxillary and midface reconstruction because of proximity, superficial positioning, and suitability for anastomosis and monitoring and because these vessels are rarely compromised by prior operations or radiotherapy.