title: Transverse cervical vessels as recipient vessels in oral and maxillofacial microsurgical reconstruction after former operations with or without radiotherapy.
abstract: BACKGROUND
  The purpose of this study was to investigate the reliability and outcome of using the transverse cervical vessel (TCV) as a recipient vessel for microvascular reconstruction in patients whose vessels in the neck region are unavailable because of previous surgery or radiotherapy.
  
  
  METHODS
  Between January 2012 and August 2014, secondary head and neck reconstruction was performed using the TCV as a recipient vessel in eight patients who had undergone previous neck dissection and radiation therapy (n = 5). Five patients had a recurrent carcinoma, one had undergone an operation for scar release and two had been treated surgically for a second primary cancer. The anterolateral thigh flap (ALT), anteromedial thigh flap (AMT), and fibular flap were used for the reconstruction. Clinical data were recorded for each patient.
  
  
  RESULTS
  All of the ipsilateral transverse cervical arteries were found to be free of disease. The second free flap was revascularized using the TCVs (n = 6) or the external (n = 1) or internal (n = 1) jugular vein. The free flaps used for the reconstruction included the ALT flap (n = 6), AMT flap (n = 2), and fibular flap (n = 1). All of the flaps survived without vascular events, and the patients healed without major complications. The mean follow-up time was 11 months. One patient died of distant metastases during follow-up.
  
  
  CONCLUSIONS
  In patients who have previously undergone neck surgery with or without radiotherapy, the TCVs are reliable and easily accessible recipient vessels for microsurgical reconstruction in the oral and maxillofacial region. If the transverse cervical vein is unavailable, the internal or external jugular vein should be dissected carefully to serve as an alternative for microvascular anastomoses.
authors.affiliation: Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, People's Republic of China. xzf7090@hotmail.com.|Department of Oral Maxillofacial Surgery, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, People's Republic of China. xzf7090@hotmail.com.
authors.forename: Zhong-fei
authors.initials: ZF
authors.lastname: Xu
authors.affiliation: Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, People's Republic of China. duanwy2013@163.com.|Department of Oral Maxillofacial Surgery, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, People's Republic of China. duanwy2013@163.com.
authors.forename: Wei-yi
authors.initials: WY
authors.lastname: Duan
authors.affiliation: Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, People's Republic of China. zej980980@hotmail.com.|Department of Oral Maxillofacial Surgery, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, People's Republic of China. zej980980@hotmail.com.
authors.forename: En-jiao
authors.initials: EJ
authors.lastname: Zhang
authors.affiliation: Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, People's Republic of China. baishuang1205@sina.com.|Department of Oral Maxillofacial Surgery, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, People's Republic of China. baishuang1205@sina.com.
authors.forename: Shuang
authors.initials: S
authors.lastname: Bai
authors.affiliation: Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, People's Republic of China. tianyu198941@163.com.|Department of Oral Maxillofacial Surgery, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, People's Republic of China. tianyu198941@163.com.
authors.forename: Yu
authors.initials: Y
authors.lastname: Tian
authors.affiliation: Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, People's Republic of China. tan.xue.xin@hotmail.com.|Department of Oral Maxillofacial Surgery, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, People's Republic of China. tan.xue.xin@hotmail.com.
authors.forename: Xue-xin
authors.initials: XX
authors.lastname: Tan
authors.affiliation: Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, People's Republic of China. lfyhjk@126.com.|Department of Oral Maxillofacial Surgery, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, People's Republic of China. lfyhjk@126.com.
authors.forename: Fa-yu
authors.initials: FY
authors.lastname: Liu
authors.affiliation: Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, People's Republic of China. changfusun@hotmail.com.|Department of Oral Maxillofacial Surgery, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, People's Republic of China. changfusun@hotmail.com.
authors.forename: Chang-fu
authors.initials: CF
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002294:Carcinoma, Squamous Cell / Q000534:rehabilitation / Q000628:therapy; D044964:Cervicoplasty / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation*; D006258:Head and Neck Neoplasms / Q000534:rehabilitation* / Q000628:therapy; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009333:Neck / Q000098:blood supply; D037981:Neck Dissection; D009367:Neoplasm Staging; D019647:Oral Surgical Procedures; D011379:Prognosis; D011879:Radiotherapy Dosage; D019651:Plastic Surgery Procedures / Q000379:methods*; D013515:Surgery, Oral