Management of large head and neck defects in the vessel-depleted neck.
Journal
Current opinion in otolaryngology & head and neck surgery
ISSN: 1531-6998
Titre abrégé: Curr Opin Otolaryngol Head Neck Surg
Pays: United States
ID NLM: 9417024
Informations de publication
Date de publication:
01 Aug 2024
01 Aug 2024
Historique:
medline:
4
7
2024
pubmed:
4
7
2024
entrez:
4
7
2024
Statut:
ppublish
Résumé
Surgery, radiation, and chemotherapy are often utilized in the treatment of head and neck cancer. These treatments can cause extensive scarring within the neck and can limit the viability of recipient vessels for further microvascular reconstruction. Patients with vessel-depleted necks provide a significant challenge for microvascular surgeons and are a topic of much discussion in the field. While reconstruction in the vessel-depleted neck is an active area of interest, the patient population is rare. Therefore, single institution series with small numbers comprise the majority of published literature. Recent publications describe techniques for identifying adequate recipient vessel options outside of the field of treatment with excellent free flap outcomes. Further, recent summary articles describe techniques for addressing issues with pedicle length that can arise when using vessels that are far from the defect to be reconstructed. When viable vessel options are available within the treatment field, these recipient vessels can be used with good reliability and free flap success. If in-field recipient vessels are not available, minimal access incisions can be used to identify superficial temporal, angular, contralateral facial, or transverse cervical vessels. Further away from the treatment field, internal mammary vessels can be harvested through open or robotic approaches. If the use of these distant vessels creates issues with pedicle length, interposition vein grafts, arteriovenous (AV) loops, or flow-through flaps can be used to augment vessel length.
Identifiants
pubmed: 38963437
doi: 10.1097/MOO.0000000000000980
pii: 00020840-202408000-00013
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
278-281Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
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