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.