Utility of "open-Y" anastomosis technique in the use of superior thyroid artery as recipient vessel for head and neck reconstruction with free flap.

Abstract

The superior thyroid artery (STA) is the most commonly used recipient vessel in free tissue transfer for head and neck reconstruction. Size discrepancy between recipient and donor vessels might affect the patency rate. The objective of this study was to compare the outcomes of the "open-Y" technique in end-to-end anastomoses between the STA and donor arteries to those of conventional anastomoses to the STA. A total of 337 patients with free tissue transfer for head and neck reconstruction with the STA as the recipient artery were recruited between September 2011 and August 2013. The "open-Y" technique of anastomosis was used in 72 cases, whereas the conventional technique was applied in 256 cases. The arterial anastomotic site-related complications and size discrepancy rates of both groups were evaluated and compared. The flap success rate was 98.6% (71/72) in the "open-Y" group, which was similar to the conventional group [97.4% (245/252); P = 0.999]. Size discrepancy rate was higher in the "open-Y" group [48/72(66.7%)] compared to that in the conventional group [31/265(11.7%), P < 0.001]. There was no significant difference regarding arterial anastomotic site-related complications between the "open-Y" and conventional groups (1.4% vs.4.2%; P = 0.473). Others complications, including re-exploration, venous thrombosis, hematoma, fistula, infection, partial flap necrosis and total flap necrosis, had similar presentations. The utility of the "open-Y" technique, applied to STA as a recipient vessel, appeared to be a reasonable option for head and neck reconstruction. This technique seems to be promising for cases with vessels size discrepancy. © 2015 Wiley Periodicals, Inc. Microsurgery 36:391-396, 2016.