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
