ORIGINAL ARTICLE VESSEL-DEPLETED NECK: TECHNIQUES FOR ACHIEVING MICROVASCULAR RECONSTRUCTION

Abstract: Background. In the neck, the recipient vessels most frequently used for microsurgical reconstruction are compro-mised by prior surgery and radiation. Methods. We conducted a retrospective chart review of all patients who underwent microvascular reconstruction between July 2001 and June 2005. Donor vessels, vein grafts, and flap survival were examined. Results. Fourteen of 197 patients (7%) were identified with a vessel-depleted neck. All patients had undergone a prior neck dissection and radiation (100%) or chemoradiation (42%). Free flap revascularization was achieved using the transverse cervi-cal artery with a vein graft and a cephalic vein (4 patients), thora-coacromial artery and cephalic vein (3 patients), internal mam-mary artery and vein (3 patients), and inferior thyroid artery and cephalic vein (1 case). In 3 patients, the reverse flow thoraco-dorsal artery and cephalic vein were used to vascularize the scapular flap. Conclusion. The cephalic vein, transverse cervical, internal mammary, and thoracoacromial vessels represent reliable alter-natives in the vessel-depleted neck. VC 2007 Wiley Periodicals