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An algorithm for recipient vessel selection in microsurgical head and neck reconstruction.

Hui-Ling Chia1, Chin-Ho Wong, Bien-Keem Tan

  • 1Department of Plastic Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore.

Journal of Reconstructive Microsurgery
|October 27, 2010
PubMed
Summary

This study presents a reliable algorithm for selecting recipient vessels in head and neck free tissue transfer. The algorithm prioritizes specific arteries and veins, ensuring successful microvascular reconstruction.

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Area of Science:

  • Plastic Surgery
  • Microsurgery
  • Head and Neck Surgery

Background:

  • Free tissue transfer is crucial for head and neck reconstruction.
  • Identifying suitable recipient vessels is critical for flap survival.
  • Previous algorithms lack comprehensive guidance for vessel selection.

Purpose of the Study:

  • To present a detailed algorithm for recipient vessel selection in head and neck free tissue transfer.
  • To improve the reliability and success rate of microvascular reconstructions in this complex anatomical region.

Main Methods:

  • Retrospective analysis of 88 consecutive free flaps in 85 patients undergoing head and neck reconstruction.
  • Evaluation of recipient artery and vein selection based on patient factors and surgical approach.
  • Documentation of vessel usage frequency and rationale for selection.

Main Results:

  • The superior thyroid artery was the most frequently used recipient artery (61%).
  • The facial artery (14%) is preferred when neck dissection is absent; superficial temporal artery (11%) is chosen for patients with prior neck dissection or radiotherapy.
  • Recipient vein selection correlated with the chosen artery, prioritizing internal jugular vein branches.

Conclusions:

  • The developed algorithm provides a reliable framework for selecting appropriate recipient arteries and veins in head and neck free tissue transfer.
  • This systematic approach enhances the predictability and success of microvascular reconstructions.
  • The algorithm accounts for patient-specific factors like prior surgery or radiation therapy.