Dorsal scapular artery as a recipient vessel in the vessel‐depleted neck during free tissue transfer in head and neck reconstruction

Rosko, Andrew J.; Ryan, Jesse; Wizauer, Eric; Ibrahim, Mohannad; Srinivasan, Ashok; Stucken, Chaz L.; Spector, Matthew E.

doi:10.1002/hed.24785

Cited by 21 publications

(13 citation statements)

References 19 publications

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“…23 In these cases, other arteries must be considered, such as the facial, transverse cervical, internal mammary, and dorsal scapular arteries. 52,53 There are many factors to consider when deciding on recipient vessels, including vascular pedicle length, caliber, flow, treatment effects and pedicle geometry. The reconstructing surgeon should be cognizant, however, of the potential effects of using the superior thyroid artery on thyroid function and should monitor this post-operatively.…”

Section: Discussionmentioning

confidence: 99%

Hypothyroidism and Wound Healing After Salvage Laryngectomy

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Hypothyroidism and Wound Healing After Salvage Laryngectomy

et al. 2017

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“…Vieira et al [62] also reported a case in which a vastus lateralis free flap was utilized for clival reconstruction due to osteoradionecrosis secondary to proton beam therapy. Another approach using the transmaxillary corridor to tunnel the pedicle across the face in the maxillary subcutaneous tissue for contralateral facial vessel anastomosis has also been described [63] .…”

Section: Free Microvascular Tissue Transfersmentioning

confidence: 99%

Anterior skull base reconstruction: a contemporary review

Naik¹,

Lancione²,

Parikh³

et al. 2021

PAR

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Anterior skull base (ASB) defects present a significant challenge in head and neck reconstructive surgery. The main goal of skull base reconstruction is to create a watertight separation between the intracranial cavity and aerodigestive tract. Successful reconstruction aims to prevent cerebrospinal fluid (CSF) leak, pneumocephalus, and a range of infectious manifestations. Functional outcomes and cosmesis are also critical considerations when developing a reconstructive plan. Advancements with endoscopic endonasal approaches have revolutionized skull base surgery but also have created new reconstructive challenges due to the narrow operative corridor, especially for extensive defects or salvage cases where microvascular free tissue transfer is required. Though a variety of techniques including local, regional, and free flaps have been described, ASB reconstruction remains a difficult undertaking due to the complex anatomy and high risk for post-operative complications. This review provides a comprehensive discussion of available reconstructive techniques that can be used after both open and endoscopic ASB resections to help determine the optimal reconstruction for a variety of defects.

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“…Recipient vessels outside of the reconstruction zone have also been proposed. The dorsal scapular artery (Rosko et al, 2017), internal mammary vessels (Schneider et al, 2012), internal mammary artery perforators (Scaglioni et al, 2020), and lateral thoracic artery (Ibrahim et al, 2019) are far from the damaged zone and are available in reconstruction. In vessel‐depleted necks, some rarely used recipient vessels, such as the thoracoacromial (Harris et al, 2002) and internal mammary vessels (Urken et al, 2006), have been used.…”

Section: Disscussionmentioning

confidence: 99%

Recipient vessel selection for multiple free flap transfers in head and neck reconstruction at different periods

et al. 2021

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Background Treatment decisions can be challenging in patients undergoing multiple oropharyngeal microsurgical reconstructions at different periods by various causes. We, retrospectively, reviewed patients with at least three consecutive free flap reconstructions to determine the optimal strategy for selecting recipient vessels. Methods Then, 36 patients (33 men and 3 women) who underwent at least 3 microsurgical reconstructions with a total of 51 free flap transfers for head and neck defects were included in this report. The most common reason for multiple microsurgical reconstructions was recurrent disease. For reconstructions, recipient vessel candidates on the same side of the head and neck were prioritized; if ipsilateral vessels were unavailable, contralateral recipient vessels, which might necessitate vein grafts, were used. Results The most common reconstructions were anterolateral thigh flaps (19 cases). The most commonly used contralateral recipient vessels were the superior thyroid artery, facial artery, and external jugular vein. All vessel anastomoses were performed using the end‐to‐end method. Postoperative complications occurred at the sites of 26 free flap reconstructions. The overall flap reconstruction success rate in patients with at least three surgeries was 90.2%. The median follow‐up duration was 25.8 months. During follow‐up, 26 patients survived until the end of follow‐up. Conclusions In patients undergoing multiple free flap reconstructions, recipient vessels on the ipsilateral side that have not been subjected to radiation should be selected first. Recipient vessels contralateral to the reconstruction side can then be selected; however, they may require vein grafts. Finally, distant healthy recipient vessels can be selected through vein grafting.

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Dorsal scapular artery as a recipient vessel in the vessel‐depleted neck during free tissue transfer in head and neck reconstruction

Abstract: The dorsal scapular artery is a viable recipient vessel during head and neck reconstruction in the vessel-depleted neck.

Cited by 21 publications

References 19 publications

Hypothyroidism and Wound Healing After Salvage Laryngectomy

Hypothyroidism and Wound Healing After Salvage Laryngectomy

Anterior skull base reconstruction: a contemporary review

Recipient vessel selection for multiple free flap transfers in head and neck reconstruction at different periods

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