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

E. Prisman, P. Baxter, E. Genden
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引用次数: 3

Abstract

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.
改良颈横动静脉进行复杂头颈部重建
背景放化疗是声门和咽部亚位的主要治疗方式。在这种情况下,复发或二次原发的处理是一个外科挑战,需要复杂的自由皮瓣重建。有效重建的主要障碍之一是合适的受体血管的可用性。我们建议颈横动脉(TCA)是复杂头颈部重建的可行选择。方法对230例连续游离组织重建病例进行回顾性分析。结果应用TCA进行动脉吻合40例。26例患者既往接受过治疗,其中13例接受过综合治疗。无微血管游离皮瓣失败,5例轻微皮瓣并发症。结论:我们的经验表明,TCA是复杂头颈部重建的可行选择,特别是在先前进行过全面颈部清扫或放疗的情况下。此外,TCA的位置为微血管吻合提供了有利的椎弓根几何形状。
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14 weeks
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