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Cephalic vein transposition for head and neck reconstruction: reliable source of recipient vein
Isis Scomacao, Sagar Rambhia, Michelle Djohan, Richard Drake, and Risal Djohan.
Cleveland Clinic
2020-02-15
Presenter: Michelle Djohan
Affidavit:
I certify that this represents the original work of the resident.
Director Name: Steven Bernard
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Purpose: The aim of this study was to examine and quantify the use and range of the cephalic vein transposition as an option for one-sided venous anastomosis for head and neck reconstruction.
Methods: Six fresh cadavers (12 cephalic veins) were systemically dissected. The incision started using an open technique with around 4cm longitudinal incision at the level of antecubital fossa. Once the cephalic vein was identified, tributaries were ligated and dissected. Serial incisions were performed along the vein course. The dissection then continued until the junction with the subclavian vein at the deltopectoral groove. After all vein length was free, it was transposed to the face at the level of the superior helix through a subcutaneous tunnel. The vein length was measured in situ, and also the remained length after the superior helix.
Results: Of the twelve cephalic veins, nine were suitable for study and transposition. Mean cadaveric age was 72.55±9.08, BMI 24.2±5.39, height 180±50cm, and distance to clavicle-tragus 12.66±1.56cm. The average length of the vein in situ was 35±2.96cm and 34.94±1.86cm after dividing it. After vein transposition, the remained length at the level of the superior helix was 9.16±2.58cm. Three cephalic veins were unable to be harvested due to severe venous thrombosis and fibrosis.
Conclusions: The cephalic vein offers a viable option for head and neck reconstruction with adequate range. Such a technique requires only one venous anastomosis versus vein grafts and typically is feasible regardless of extensive surgical resection and radiation at the recipient site.
