Extended Supraclavicular Fasciocutaneous Island Flap Based on the Transverse Cervical Artery for Head and Neck Reconstruction After Cancer Ablation

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.

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The retrograde transverse cervical artery as a recipient vessel for free tissue transfer in complex head and neck reconstruction with a vessel‐depleted neck

Microsurgery ◽

10.1002/micr.30193 ◽

2017 ◽

Vol 37 (8) ◽

pp. 902-909 ◽

Cited By ~ 2

Author(s):

Pedro Ciudad ◽

Mouchammed Agko ◽

Oscar J. Manrique ◽

Shivprasad Date ◽

Kidakorn Kiranantawat ◽

...

Keyword(s):

Head And Neck ◽

Free Tissue Transfer ◽

Head And Neck Reconstruction ◽

Recipient Vessel ◽

Neck Reconstruction ◽

Tissue Transfer ◽

Cervical Artery ◽

Transverse Cervical Artery

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Third Place — Resident Clinical Science Award 1995: Transverse Cervical Artery Fasciocutaneous Free Flap for Head and Neck Reconstruction: Initial Anatomic and Dye Studies

Otolaryngology ◽

10.1177/019459989511300507 ◽

1995 ◽

Vol 113 (5) ◽

pp. 564-568

Author(s):

Beth Rhodes Mizerny ◽

Marie-Lucie Lessard ◽

Martin Jacob Black

Keyword(s):

Head And Neck ◽

Free Flap ◽

Soft Tissues ◽

Trapezius Muscle ◽

Blue Dye ◽

Head And Neck Reconstruction ◽

Neck Reconstruction ◽

Cervical Artery ◽

Artery Branch ◽

Transverse Cervical Artery

METHOD: The bilateral transverse cervical arteries of 16 fresh cadavers were exposed by an infraclavicular midline approach, Each artery was cannulated, and methylene blue dye was infused to delineate the skin territory subserved by the vessel. The two major infusion skin patterns obtained allowed fashioning of a thin fasciocutaneous flap incorporating supraclavicular skin, which was based on the transverse cervical artery; or a larger flap additionally incorporating upper back skin and varying amounts of trapezius muscle, when the artery had a dorsal scapular artery branch. Depending on the skin pattern, either scapula or clavicle could be transferred with the other soft tissues. RESULTS: The skin territory of the transverse cervical artery is caused to vary by the presence or absence of its dorsal scapular artery branch, The supraclavicular portion of the flap is recommended for repair of facial and nasal lesions because of its close match in color and texture to facial skin. Oral lesions can also be reconstructed with this flap because of its pliability. CONCLUSION: The free flap based on the transverse cervical artery pedicle appears to be a useful addition to the armamentarium of flaps for head and neck reconstruction. Clinical use of the flap is ongoing and will be subsequently reported.

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