(A614) Recipient Superficial Temporal Vessels: A Minimally Invasive Option for Head and Neck Free Flap Reconstruction

Introduction: Controversy exists regarding the use of the superficial temporal (ST) system as recipient vessels for free flap reconstruction; however, the ST system can be less invasive than cervical vessel access while still providing reliable recipient vasculature. Here, we present a series of patients undergoing head and neck free flap reconstruction with ST recipient vessels.

Methods: Patients undergoing ST recipient free flap reconstructions from 2017 until 2024 at a single institution were assessed via retrospective chart review. Demographics, medical history, surgical details including need for tracheostomy, inpatient course, and outpatient follow up were collected for each patient and analyzed.

Results: 21 patients (15 male, mean age 69.8±10.3 years) were identified fitting inclusion criteria. While six patients underwent simultaneous neck exploration or neck dissection, 15 patients avoided any neck surgery at the time of free flap reconstruction. All patients without neck dissection safely avoided a tracheostomy. Average hospital stay was 5.8±1.5 days, excluding an outlier of 106 days due to comorbidities and administration of inpatient adjuvant therapy. There were 2 flap failures (one arterial and one venous) and one flap which returned to the operating room for a successful salvage after ST venous compromise. Both patients with flap failures had a single superficial temporal vein anastomosis.

Conclusions: Our series of 21 consecutive free flaps using ST recipient vessels demonstrates the viability of the ST system in appropriately selected patients to minimize invasiveness of surgery.