Using the Cephalic Vein Transposition as a Recipient Venous Drainage for Difficult Head and Neck Reconstructions

Abstract

It is sometimes difficult to have a proper recipient vein for free tissue transfer in repeated or radiated head and neck reconstructions. The purpose of this article is to report our experience of using cephalic vein transpositions in difficult recipient beds in the necks. One hundred and nine free tissue transfers were performed for head and neck reconstruction in Buddhist Tzu Chi Medical Center between September 2000 and March 2003. Six cases without available recipient veins in the necks had used the cephalic vein transposition for drainage. The cephalic veins were dissected free from the upper limb for an adequate length and turned up to the neck as recipient veins for microvascular anastomoses with the pedicle veins of the free flaps. The incidence of using the cephalic vein transposition is 5.5%. All of the six free flaps survived and healed primarily. The reconstruction time was 390.33±28.77 minutes, which was similar to that of other patients (381.02±6.83) using neck veins. The cephalic vein transposition from the arm proves to be a reliable alternative recipient vein for microvascular head and neck reconstruction when there are no suitable veins in the necks.