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Related Experiment Videos

Microvascular reconstruction after previous neck dissection.

Christian Head1, Joel A Sercarz, Elliot Abemayor

  • 1Department of Surgery, Box 951624, UCLA School of Medicine, Los Angeles, CA 90095-1624, USA.

Archives of Otolaryngology--Head & Neck Surgery
|March 12, 2002
PubMed
Summary

Free flap reconstruction is reliable for head and neck defects after neck dissection. Long pedicle flaps and contralateral vessels minimize complications, making it a viable option.

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Area of Science:

  • Head and Neck Surgery
  • Microsurgery
  • Oncology

Background:

  • Head and neck cancer treatment often involves neck dissection, which removes potential blood vessels for free flap reconstruction.
  • This can complicate microvascular reconstruction due to a limited number of cervical recipient vessels.

Purpose of the Study:

  • To assess the safety and reliability of free flap reconstruction in patients who have previously undergone neck dissection.
  • To determine if prior neck dissection contraindicates free flap surgery.

Main Methods:

  • Sixty free flaps were performed on 59 patients with a history of neck dissection for head and neck cancer.
  • Flap choices included radial forearm, fibula, rectus abdominis, subscapular system, and iliac crest flaps.

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Main Results:

  • Recipient vessels in the neck dissection area were used in about half of selective neck dissection cases; contralateral vessels were used in radical neck dissection cases.
  • No vein grafts were required, and only one arterial anastomosis needed revision due to tension.
  • There were no instances of free flap failure.

Conclusions:

  • Free flap reconstruction is highly successful in head and neck defects following neck dissection.
  • The use of free flaps with long vascular pedicles eliminated the need for vein grafts, contributing to successful outcomes.
  • Previous neck dissection should not preclude patients from undergoing microvascular reconstruction.