Contemporary Marking Technique of End-to-Side Venous Anastomosis with Internal Jugular Vein in Head and Neck Free Flap Cases: An Experience of 200 Cases.

BACKGROUND

Microvascular free tissue transfer is a popular option for reconstruction of the head and neck defects following tumor ablation. Many factors are involved in the achievement of a satisfactory outcome, namely, adequate selection of the donor flap and recipient vessels, proficient anastomosis technique and postoperative care including flap monitoring. Preferential use of end-to-side anastomosis to the internal jugular vein in head and neck reconstruction offers various advantages and has consistently yielded outstanding results.

PURPOSE

Presented is a series of 200 consecutive cases at one institution over 1 year.

METHOD

In our institution, the internal jugular vein (IJV) has had the first priority in the selection of a recipient vein in free-flap head and neck reconstruction. An end-to-side anastomosis with the internal jugular vein has several advantages.

RESULTS

We have devised a simple technique of marking the point of anastomosis with a needle prick at two points taking the diameter of pedicle vein to aid in identification of point of anastomosis.

CONCLUSION

This method is very reliable to ascertain the suitable lie of the pedicle vein. The diameter of the lumen for anastomosis is maintained. We had a success rate of 100% with all the cases we applied this technique on.