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[Microvascular anastomoses in reconstructive head and neck surgery]

S Remmert1

  • 1Medizinische Universität zu Lübeck, Klinik für Hals-, Nasen- und Ohrenheilkunde.

Laryngo- Rhino- Otologie
|April 1, 1995
PubMed
Summary

This study details microvascular tissue transplant techniques in 57 cases, focusing on arterial and venous anastomoses. Researchers optimized methods for complex reconstructions, including those after neck dissection and radiation.

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Area of Science:

  • Otolaryngology
  • Microsurgery
  • Vascular Surgery

Context:

  • 57 microvascular tissue transplants performed at the University of Lübeck's ENT Department over three years.
  • 129 anastomoses, including 61 arterial and 68 venous, were analyzed.
  • Focus on reconstructive surgery for head and neck defects.

Purpose:

  • To describe the microvascular anastomosis techniques used for tissue transplants.
  • To analyze the frequency distribution of recipient vessels.
  • To outline the characteristics and rules for microvascular anastomosis in challenging cases, such as post-radiation or post-neck dissection scenarios.

Summary:

  • Arterial anastomoses were consistently end-to-end.
  • Venous anastomoses were primarily end-to-side with the jugular vein; venous interponates were used for long distances.

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  • Alternative recipient vessels like the cephalic vein or thyroid capsular veins were utilized when neck veins were unavailable.
  • Transplants were fitted before anastomosis, particularly for jejunal and osteomyocutaneous flaps, to accommodate functional requirements.
  • Two transplants were lost due to postoperative venous thrombosis, highlighting a key complication.

    • Impact:

    • Provides insights into optimizing microvascular anastomosis in head and neck reconstruction.
    • Offers practical guidance for surgeons dealing with irradiated tissues or post-neck dissection defects.
    • Contributes to the understanding of managing complex vascular reconstructions in challenging oncologic and reconstructive scenarios.