Recipient Vessels: Voice Reconstruction

The major cause for voice reconstruction is represented by oncological resections secondary to pharyngeal and laryngeal cancer. In these cases, a total laryngopharyngectomy may be necessary, along with neck dissection and adjuvant radiotherapy, leaving the patient with a defect of the upper digestive tract and the loss of a mechanism for voice production. Microsurgery has become the standard approach for these cases, and free flaps frequently used include fasciocutaneous flaps, like radial forearm and anterolateral thigh flap, but also enteric flaps. The rich vascular anatomy of the neck allows the surgeon to choose among different potential recipient vessels for anastomosis. These include the first branches of the external carotid artery and corresponding veins but also the external and internal jugular veins may be considered. In challenging cases, like vessel-depleted necks, it is necessary to consider other recipient vessels, such as the transverse cervical artery, the thoracoacromial vessels, and the cephalic vein. This chapter focuses on selection of recipient vessels for voice reconstruction.