Effectiveness of the trapezius vein in the reconstruction of intraoral defects with bare neck.

In head and neck cancer reconstruction, the transverse cervical artery is a good alternative vessel when the appropriate recipient vessels cannot be identified because of preoperative radiation and radical neck dissection. Selecting the appropriate recipient vein is essential for a successful intraoral reconstruction. We attempted to determine which veins are candidate partners of the transverse cervical artery by anatomically examining 10 necks (2 sides of the neck in 5 cadavers) in a cadaver study. Three types of veins (suprascapular vein, transverse cervical vein, and descending vein from the trapezius muscle) were selected as recipient vein candidates, and the characteristics of each vein were analyzed. Clinically, we also examined which vessels were chosen as recipient veins in 13 patients in whom intraoral reconstruction with bare neck was performed using the transverse cervical artery as recipient. The descending vein from the trapezius muscles (trapezius vein) was used most frequently, followed by the transverse cervical vein. The transverse cervical vein could be considered an appropriate recipient vein, but it is prone to damage from neck dissection in some cases. Therefore, the use of the trapezius vein can aid in the successful reconstruction in such patients.