Superficial Temporal Artery and Vein as Alternative Recipient Vessels for Intraoral Reconstruction With Free Flaps to Avoid the Cervical Approach With the Resulting Need for Double Flap Transfer in Previously Treated Necks

• DOI: 10.3389/fonc.2022.879086
• Publication Date: 2022-07-07T04:39:43Z
• Authors: Lucas M. Ritschl; Minli Niu; Katharina Pippich; Philia Schuh; Niklas Rommel; Andreas M. Fichter; Klaus-Dietrich Wolff; Jochen Weitz
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Oncology; Oncology ; intraoral reconstruction ; temporal vessel ; microvascular anastomosis ; osteoradionecrosis ; free fibula flap; osteoradionecrosis; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; intraoral reconstruction; temporal vessel; free fibula flap; microvascular anastomosis; RC254-282; ddc:

Microvascular reconstruction remains challenging in previously operated and irradiated patients, especially when double flaps seem to be the only solution due osteoradionecrosis. An alternative reconstructive option could microvascular anastomosis temporal vessels avoid obligatory cervical incision.All consecutive cases between January 2013 2020 that underwent either mandibular resection with a free fibula flap (FFF) another soft tissue (group I) or pure intraoral an FFF radial forearm (RFF) II) were included. Patients' general information, indication extent of surgery, time ischemia, total duration hospital stay as well incidence complications retrospectively recorded analyzed.Seventeen 11 In group I, was combined RFF (n = 9), anterolateral thigh (ALT, n 7), latissimus dorsi 1). Group II consisted six FFFs five RFFs. Operation hospitalization significantly shorter (p < 0.001 p 0.025), whereas ischemic I 0.002). All patients required tracheostomy, while four did 0.004). The complication rate regarding hematoma removal, revision anastomosis, loss, delirium, sepsis, pleural effusion, pneumonia, pulmonary artery embolism showed no significant differences two groups.The superficial served versatile recipient for led reduced operation time, duration, primary tracheostomy. Thus, this approach may help incision patients.