Thoracoacromial vessels as recipients for head and neck reconstruction and cause of vascular complications.
BACKGROUND
The choice of recipient vessels is an important factor for successful head and neck reconstruction. Finding good recipient vessels for neck microsurgery can be difficult after patients have undergone radiation therapy, previous neck dissection or developed neck infections due to pharyngocutaneous fistulae. Thoracoacromial arteries and veins can be good alternatives to common recipient vessels in such patients. We reviewed the complications, advantages and disadvantages associated with using thoracoacromial arteries and veins as recipient vessels.


METHODS
We reviewed eight patients whose thoracoacromial arteries and veins served as recipient vessels for head and neck reconstruction between 2002 and 2009. Preoperative status, reconstruction method and operative outcomes with complications were evaluated.


RESULTS
Postoperative complications related to microsurgical anastomosis developed in two of the eight patients. One arterial and venous thrombosis developed in each patient. We considered that the arterial thrombosis was derived from a technical problem with the operation and the venous thrombosis was derived from postoperative external pressure.


CONCLUSIONS
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.
Division of Plastic Surgery, National Cancer Center Hospital Central and East, Chiba, Japan. sonoda@md.okayama-u.ac.jp
Satoshi
S
Onoda
Minoru
M
Sakuraba
Takayuki
T
Asano
Shimpei
S
Miyamoto
Ryuichi
R
Hayashi
Masao
M
Asai
Yoshihiro
Y
Kimata
D000174:Acromion / Q000098:blood supply*; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D001158:Arteries / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D013524:Surgical Flaps / Q000098:blood supply*; D013895:Thoracic Arteries / Q000601:surgery / Q000637:transplantation*; D016157:Vascular Fistula / Q000209:etiology / Q000601:surgery; D014680:Veins / Q000637:transplantation; D020246:Venous Thrombosis / Q000209:etiology / Q000628:therapy; D014945:Wound Healing / Q000502:physiology