P77. The Superficial Temporal Vessels A Reliable Recipient in Head & Neck Microsurgery Review of 100 Consecutive Cases

PURPOSE: Despite previous reports of successful utilization in head-and-neck microsurgery the superficial temporal vessels continue to maintain a reputation of unreliability. METHODS: Retrospective review of 100 head and neck reconstructions. The evaluation included type of reconstruction, incidence of complete or partial flap loss, thrombosis rate, anastomotic revision rate, vein utilization (Superficial Temporal Vein [STV] vs. Middle Temporal Vein [MTV]), vein coupler diameter, and flap type, demographic data and comorbidities. RESULTS: 100 patients (30 males and 70 females). Most frequent etiologies were malignancy (34), Bell’s palsy (30) trauma (11) and congenital (6). Sixteen patients underwent skull base, orbital, or cranial coverage: 11 Vastus Lateralis flaps, 3 ALT flaps, 1 TAPAS, 1 Platysma flap and 1 allotransplantation. Eighty-eight free functional Gracilis muscle flaps were utilized for facial reanimation. Average follow-up of 34.1months. The Superficial Temporal Artery was anastomosed in an end-to-end fashion in all cases. STV was identified and utilized for end-to-end anastomosis with a venous coupler in 85 patients (87 anastomosis). When unavailable, the adjacent MTV was successfully anastomosed in 15 patients (17 anastomosis). Venous coupler diameters ranged from 1.0-3.0mm. 3mm in 4 venous anastomoses, 2.5mm in 24, 2.0mm in 70, and 1.5mm in 6. No complete or partial flap losses, perioperative deaths or microvascular thrombosis were encountered, no anastomotic revisions were required. One seroma and 1 hematoma, 3 Group-A streptococcus infections, all requiring I&D and IV-antibiotics. CONCLUSION: Superficial temporal vessels are a reliable recipient in Head & Neck microsurgical reconstruction. When a diminutive STV was encountered, sizable MTV was identified within temporal fat-pad allowing successful microsurgical anastomosis.