Abstract
BackgroundThe purpose of this study was to investigate the reliability and outcome of using the transverse cervical vessel (TCV) as a recipient vessel for microvascular reconstruction in patients whose vessels in the neck region are unavailable because of previous surgery or radiotherapy.MethodsBetween January 2012 and August 2014, secondary head and neck reconstruction was performed using the TCV as a recipient vessel in eight patients who had undergone previous neck dissection and radiation therapy (n = 5). Five patients had a recurrent carcinoma, one had undergone an operation for scar release and two had been treated surgically for a second primary cancer. The anterolateral thigh flap (ALT), anteromedial thigh flap (AMT), and fibular flap were used for the reconstruction. Clinical data were recorded for each patient.ResultsAll of the ipsilateral transverse cervical arteries were found to be free of disease. The second free flap was revascularized using the TCVs (n = 6) or the external (n = 1) or internal (n = 1) jugular vein. The free flaps used for the reconstruction included the ALT flap (n = 6), AMT flap (n = 2), and fibular flap (n = 1). All of the flaps survived without vascular events, and the patients healed without major complications. The mean follow-up time was 11 months. One patient died of distant metastases during follow-up.ConclusionsIn patients who have previously undergone neck surgery with or without radiotherapy, the TCVs are reliable and easily accessible recipient vessels for microsurgical reconstruction in the oral and maxillofacial region. If the transverse cervical vein is unavailable, the internal or external jugular vein should be dissected carefully to serve as an alternative for microvascular anastomoses.
Highlights
The purpose of this study was to investigate the reliability and outcome of using the transverse cervical vessel (TCV) as a recipient vessel for microvascular reconstruction in patients whose vessels in the neck region are unavailable because of previous surgery or radiotherapy
Adjuvant radiotherapy with neck dissection for the management of head and neck cancer might have a positive effect on disease-free survival; it might have a negative effect on the vascular bed in the radiotherapy field [1]
Patients Between January 2012 and August 2014, 156 cases of microsurgical oral and maxillofacial reconstruction were performed at the Department of Oral and Maxillofacial Surgery, School of Stomatology of China Medical University
Summary
The purpose of this study was to investigate the reliability and outcome of using the transverse cervical vessel (TCV) as a recipient vessel for microvascular reconstruction in patients whose vessels in the neck region are unavailable because of previous surgery or radiotherapy. In cases in which a patient develops a recurrent. Xu et al World Journal of Surgical Oncology (2015) 13:183 microvascular tissue transfer in patients who have undergone neck surgery, radiation therapy, or both. The transverse cervical vessel (TCV) is occasionally described as a recipient vessel for head and neck reconstruction [6,7]. We describe the technique and evaluate the reliability of using TCVs as recipient vessels in re-operative oral and maxillofacial reconstruction in cases in which other local vessels are not available or inadequate
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