Thoracoacromial vessels as recipients for head and neck reconstruction and cause of vascular complications

Abstract

Thoracoacromial arteries and veins are good recipient vessels for patients who have undergone ablative or reconstructive surgery, radiation therapy, or have a neck infection due to complications. However, we believe that using these vessels as recipients requires specific precautions that differ from those associated with general head and neck reconstruction.

Semi‐free radial forearm flap for head and neck reconstruction in vessel‐depleted neck after radiotherapy or radical neck dissection

“…The use of venae comitantes from the transverse cervical artery is difficult because their caliber is usually small and they have poor venous flow. 30 Recently, Onoda et al 31 reported the use of thoracoacromial vessels for head and neck reconstructions. These vessels are not compromised by prior neck dissection or radiotherapy, but isolating this pedicle is difficult and pectoralis major myocutaneous flap cannot be used if required to treat a fistula for example.…”

Lateral thoracic artery as recipient vessel for head and neck free flap reconstruction in the vessel depleted neck: A case report

“…The pectoral branch of the thoracoacromial artery has been described as good alternative recipient vessel in vessel depleted neck (Harris et al, ; Onoda et al, ). In our case the lateral pedicle arising from the lateral thoracic vessel turned out to have better reach and larger caliber.…”

Effects of radiation therapy on postoperative complications and adverse events in patients with head and neck reconstruction with flaps

“…Mourad et al reported that radiation therapy significantly increased the duration of heterotopic ossification. In addition, the soft tissues of the fistula do not tend to adhere together, and the localization of abscess is difficult to clarify, permitting infection to spread and necessitating additional surgery . Blood flow through tissues is decreased in the radiation field, and spontaneous healing is also delayed.…”

“…However, the condition of the operative field is entirely altered after radiation therapy . We previously described the operative procedures for such cases . In clinical practice, operation time was significantly longer in irradiated patients than nonradiated patient .…”