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J Reconstr Microsurg 2011; 27(1): 047-056
DOI: 10.1055/s-0030-1267829
© Thieme Medical Publishers

An Algorithm for Recipient Vessel Selection in Microsurgical Head and Neck Reconstruction

Hui-Ling Chia1 , Chin-Ho Wong1 , Bien-Keem Tan1 , Kok-Chai Tan1 , Yee-Siang Ong1
  • 1Department of Plastic Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore
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Publication History

Publication Date:
25 October 2010 (online)

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ABSTRACT

This article details an algorithm we used for selection of recipient vessels in free tissue transfer to the head and neck. Eighty-eight consecutive free flaps to the head and neck were performed in 85 patients. The superior thyroid was the commonest recipient artery used (61%). The facial artery, used in 14% of our cases, is the choice vessel in instances where neck dissection is not performed. In these cases, we have to access the neck separately for recipient vessels and it can be exposed easily via a short (3-cm) incision. The superficial temporal artery (11%) is our choice vessel for patients with previous neck dissection or radiotherapy as it is well outside the previous operative or irradiated field. Other vessels such as the transverse cervical and end-to-side anastomosis to the carotid artery were also used when appropriate. Recipient vein selection depends primarily on the selected artery. Corresponding veins and large branches of the internal jugular vein (IJV) in the vicinity of the selected artery are preferred. When these are exhausted, the external jugular vein and end-to-side anastomosis to the IJV are considered. We found this algorithm to be reliable in identifying the appropriate vessels in all cases.

KEYWORDS

Recipient vessel - free flap - free tissue transfer - reliable - microsurgery

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Chin-Ho WongM.B.B.S. M.R.C.S. (Ed.) M.Med. (Surg.) F.A.M.S. (Plast. Surg.) 

Department of Plastic Reconstructive and Aesthetic Surgery

Singapore General Hospital, Outram Road, Singapore 169608

Email: wchinho@hotmail.com

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