Potential of the common facial vein as a recipient vein in free flap reconstruction

Abstract

Recipient vessel selection for free flap reconstruction depends on numerous factors and may be limited due to previous treatment. Currently, little evidence is available regarding the anatomy and reconstructive potential of the common facial vein (CFV), a tributary of the internal jugular vein (IJV). The aim of this project was to determine the diameter of the CFV at various points along its course and identify suitable landmarks to locate the CFV, to consider the vessel as a potential recipient vein in free flap reconstruction. A cadaveric study was conducted by dissecting 17 embalmed neck hemi-sections in the Keele University Medical School Anatomy Suite. Our intent was to describe the gross anatomy of the CFV in terms of diameter and relation to surrounding structures. We found the mean diameter of the CFV to be 5.9 (± 1.8) mm at its termination into the IJV. We also found the mean distance of the CFV termination into the IJV from the level of the hyoid bone was 8.0 (± 4.0) mm. The diameter of the CFV could accommodate for end-to-end anastomoses to be formed with the IJV system. The diameter also suggests the vein to be appropriate for microvascular anastomosis with commonly used free flaps. The results propose that the CFV can be found within 12 mm of the level of the hyoid bone, knowledge of which could reduce operative time and site morbidity. These findings support the CFV as a potential recipient vein in free flap reconstruction of the head and neck.

Clinical Anatomy of the Ligaments of the Face and Their Fundamental Distinguishing Features

“…The lower masseteric ligament (100%; n = 60) was a connective tissue lamina extending from the parotideomasseteric fascia at the level of the lower third of the anterior edge of the masseter muscle. The part of the connective tissue fibers of this ligament followed from the sheath of the facial vein, in cases of its typical location within this sheath (56.66% n = 34) (Figure 3) [17]. The weaving of the lower masseteric ligament as well as the upper one was limited by the superficial fascia, i.e., the SMAS.…”