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CC BY-NC-ND 4.0 · J Reconstr Microsurg Open 2019; 04(02): e54-e57
DOI: 10.1055/s-0039-1692973
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Revisiting the Transverse Cervical Artery and Vein for Complex Head and Neck Reconstruction

Eitan Prisman
1   Division of Otolaryngology–Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
,
Peter Baxter
2   Department of Otolaryngology–Head & Neck Surgery, ICAHN School of Medicine at Mount Sinai School, New York, New York
,
Eric M. Genden
2   Department of Otolaryngology–Head & Neck Surgery, ICAHN School of Medicine at Mount Sinai School, New York, New York
› Author Affiliations
Further Information

Publication History

11 May 2018

19 January 2019

Publication Date:
25 August 2019 (online)

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Abstract

Background Chemoradiotherapy is the primary treatment modality for glottic and pharyngeal subsites. Management of recurrence or second primaries in this setting is a surgical challenge requiring complex free flap reconstruction. One of the major barriers to effective reconstruction is the availability of suitable recipient vessels. We propose that the transverse cervical artery (TCA) is a viable option for complex head and neck reconstruction.

Methods A retrospective chart review of 230 consecutive free tissue reconstructive cases was performed by the senior author (EG).

Results Forty cases were identified that used the TCA for arterial anastomosis. Twenty-six patients had prior treatment, 13 of which had multimodality treatment. There were no microvasculature free flap failures and 5 minor flap complications.

Conclusions Our experience with the TCA suggests it is a viable option for complex head and neck reconstruction, particularly in the setting of prior comprehensive neck dissection or radiation. In addition, the location of the TCA provides favorable pedicle geometry for microvascular anastomosis.

Keywords

transverse cervical artery - microvascular reconstruction - head and neck reconstruction

Note

The authors would like to thank Tim Grant for preparing the figure.


 

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