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Transverse Cervical Artery: Consistent Anatomical Landmarks and Clinical Experience with Its Use as a Recipient Artery in Complex Head and Neck Reconstruction

Tessler, Oren M.D., M.B.A.; Gilardino, Mirko S. M.D., M.Sc.; Bartow, Matthew J. M.D.; St. Hilaire, Hugo M.D., D.D.S.; Womac, Daniel M.D.; Dionisopoulos, Tassos M.D.; Lessard, Lucie M.D.

Plastic & Reconstructive Surgery: March 2017 - Volume 139 - Issue 3 - p 745e–751e
doi: 10.1097/PRS.0000000000003085
Reconstructive: Head and Neck: Original Articles

Background: Many head and neck reconstructions occur in patients with extensive history of surgery or radiation treatment. This leads to complicated free flap reconstructions, especially in choosing recipient vessels in a “frozen neck.” The transverse cervical artery is an optimal second-line recipient artery in head and neck reconstruction.

Methods: Seventy-two neck sides in 36 cadavers were dissected, looking for the transverse cervical artery and transverse cervical vein. Anatomical location of these vessels, their diameter, and length were documented. A retrospective analysis on 19 patients who had head and neck reconstruction using the transverse cervical artery as a recipient artery was undertaken as well with regard to outcome of procedures, reason for surgery, previous operations, and use of vein grafts during surgery.

Results: The transverse cervical artery was present in 72 of 72 of cadaveric specimens, and was infraclavicular in two of 72 specimens. Transverse cervical artery length ranged from 4.0 to 7.0 cm, and the mean diameter was 2.65 mm. The transverse cervical vein was present in 61 of 72 cadaveric specimens, the length ranged from 4.0 to 7.0 cm, and the mean diameter was 2.90 mm. The transverse cervical artery averaged 33 mm from midline, and branched off the thyrocervical trunk at an average 17 mm superior to the clavicle. Transverse cervical artery stenosis was markedly less in comparison with external carotid artery stenosis. In a 20-year clinical follow-up study, the transverse cervical artery was the recipient artery in 19 patients. A vein graft was used in one patient, and no flap loss occurred in any of the 19 patients.

Conclusion: The transverse cervical artery is a reliable and robust option as a recipient artery in free flap head and neck reconstruction.

New Orleans, La.; and Montreal, Quebec, Canada

From the Louisiana Health Science Center–New Orleans; McGill University Health Centre; and Jewish General Hospital.

Received for publication April 6, 2016; accepted September 16, 2016.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Oren Tessler, M.D., M.B.A., 1542 Tulane Avenue, Room 734, New Orleans, La. 70112, otessl@lsuhsc.edu

©2017American Society of Plastic Surgeons