Use of the external jugular vein as the sole recipient vein in head and neck free flap reconstruction

Objective: The selection of recipient vessels suitable for microvascular anastomosis within the head and neck region is an essential element affecting patency and outcome. Our aim was to ascertain whether the use of external jugular vein as the sole recipient vein is related to an increase in free flap failure in head and neck reconstructive surgery. Methods: A retrospective review of all head and neck free flaps performed at an academic centre during a 3-year period was performed. Cases in which the external jugular vein was the lone recipient vein were analyzed. The same two surgeons completed all microvascular anastomosis. The outcome measure was free flap survival. Results: Forty-seven of 49 flaps (96%), which used the external jugular vein as the sole recipient vein, survived. The two failures resulted from venous thrombosis but were successfully salvaged. Conclusion: The free flap success rate is well within the range of figures previously reported in large studies. Use of the external jugular vein as the sole recipient vein in head and neck free flap reconstruction does not increase the risk of free flap failures. This suggests that the external jugular vein is a viable option when choosing a single recipient vein in head and neck free tissue transfers.