RSS-Feed abonnieren
DOI: 10.1055/a-2659-6863
Cephalic Vein Transposition for Head and Neck Reconstruction: An Anatomical Study
Funding None.

Abstract
Background
This study aims to evaluate the anatomical feasibility and utility of cephalic vein transposition for venous outflow in head and neck reconstruction, particularly in vessel-depleted necks.
Methods
Bilateral dissections were performed on 11 fresh cadavers to assess the cephalic vein's length, course, and suitability for transposition. The vein was freed, transected at the antecubital fossa, and transposed via a subcutaneous tunnel to the neck. Measurements were taken of the in situ vein length and the remaining length after transposition.
Results
Nineteen cephalic veins were suitable for transposition. The average in situ length was 31.40 ± 2.30 cm, and 29.59 ± 2.20 cm after division. Posttransposition, the residual length beyond the superior helix was 8.47 ± 2.53 cm. The average vein diameter was 3.12 ± 0.75 cm.
Conclusion
Cephalic vein transposition is a viable option for venous anastomosis in vessel-depleted necks, providing a long, stable venous conduit with favorable anatomical characteristics for complex head and neck reconstructions.
Publikationsverlauf
Eingereicht: 30. März 2025
Angenommen: 24. Juni 2025
Accepted Manuscript online:
18. Juli 2025
Artikel online veröffentlicht:
01. September 2025
© 2025. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Corbitt C, Skoracki RJ, Yu P, Hanasono MM. Free flap failure in head and neck reconstruction. Head Neck 2014; 36 (10) 1440-1445
- 2 Head C, Sercarz JA, Abemayor E, Calcaterra TC, Rawnsley JD, Blackwell KE. Microvascular reconstruction after previous neck dissection. Arch Otolaryngol Head Neck Surg 2002; 128 (03) 328-331
- 3 Borras JM, Barton M, Grau C. et al. The impact of cancer incidence and stage on optimal utilization of radiotherapy: methodology of a population based analysis by the ESTRO-HERO project. Radiother Oncol 2015; 116 (01) 45-50
- 4 Jacobson AS, Eloy JA, Park E, Roman B, Genden EM. Vessel-depleted neck: techniques for achieving microvascular reconstruction. Head Neck 2008; 30 (02) 201-207
- 5 Ross GL, Ang ESW, Golger A. et al. Which venous system to choose for anastomosis in head and neck reconstructions?. Ann Plast Surg 2008; 61 (04) 396-398
- 6 Vasilakis V, Patel HDL, Chen HC. Head and neck reconstruction using cephalic vein transposition in the vessel-depleted neck. Microsurgery 2009; 29 (08) 598-602
- 7 Gujral DM, Chahal N, Senior R, Harrington KJ, Nutting CM. Radiation-induced carotid artery atherosclerosis. Radiother Oncol 2014; 110 (01) 31-38
- 8 Bernard SL. Venous Salvage Using Cephalic Vein/External Jugular Vein. In: Recipient Vessels in Reconstructive Microsurgery. Cham: Springer International Publishing; 2021: 77-82
- 9 Shankhdhar VK, Yadav PS, Dushyant J, Seetharaman SS, Chinmay W. Cephalic vein: Saviour in the microsurgical reconstruction of breast and head and neck cancers. Indian J Plast Surg 2012; 45 (03) 485-493
- 10 King ICC, Mellington AJ, Jones ME, Hazari A. Cephalic vein transposition in autologous breast reconstruction salvage: a review of outcomes and implications for patient care. Eur J Plast Surg 2018; 41: 671-676
- 11 Kim KA, Chandrasekhar BS. Cephalic vein in salvage microsurgical reconstruction in the head and neck. Br J Plast Surg 1998; 51 (01) 2-7
- 12 Chan D, Rabbani CC, Inman JC, Ducic Y. Cephalic vein transposition in the vessel-depleted neck. Otolaryngol Head Neck Surg 2016; 155 (02) 367-368
- 13 Horng SY, Chen MT. Reversed cephalic vein: a lifeboat in head and neck free-flap reconstruction. Plast Reconstr Surg 1993; 92 (04) 752-753
- 14 Rahman MF, Ahsan MA, Shaikh SA, Khan MU, Ullah S. Use of cephalic vein for venous anastomosis in head and neck reconstruction: a case series. Eplasty 2020; 20: e9
- 15 Xu H, Jazayeri L, Matros E, Henderson PW. Anatomy, exposure, and preparation of recipient vessels in microsurgical head and neck reconstruction. J Reconstr Microsurg 2021; 37 (02) 97-110
- 16 Martinez DC, Badhey A, Cervenka B, Zender C, Tang A, Patil Y. Surgical techniques for head and neck reconstruction in the vessel-depleted neck. Facial Plast Surg 2020; 36 (06) 746-752
- 17 Jacobson AS, Smith M, Urken ML. Internal mammary artery and vein as recipient vessels in head and neck reconstruction. JAMA Otolaryngol Head Neck Surg 2013; 139 (06) 623-628
- 18 Au FC. The anatomy of the cephalic vein. Am Surg 1989; 55 (10) 638-639
- 19 Reid CD, Taylor GI. The vascular territory of the acromiothoracic axis. Br J Plast Surg 1984; 37 (02) 194-212
- 20 Loukas M, Myers CS, Wartmann ChT. et al. The clinical anatomy of the cephalic vein in the deltopectoral triangle. Folia Morphol (Warsz) 2008; 67 (01) 72-77
- 21 Watson JS. Experimental microvascular anastomoses in radiated vessels: a study of the patency rate and the histopathology of healing. Plast Reconstr Surg 1979; 63 (04) 525-533
- 22 Lin K-W, Huang TC-T, Cheng H-T. Utilization of anterolateral thigh flap and transverse cervical recipient vessels for head and neck cancer patients with former neck dissection and irradiation: a case series study. Ann Plast Surg 2019; 82 (04) 415-419
- 23 Audolfsson T, Rozen WM, Wagstaff MJ, Whitaker IS, Acosta R. A reliable and aesthetic technique for cephalic vein harvest in DIEP flap surgery. J Reconstr Microsurg 2009; 25 (05) 319-321
- 24 Ishii N, Kishi K. Determining length and position of pedicle vessels using a flap model with vascular tape. Plast Reconstr Surg Glob Open 2016; 4 (11) e1161
- 25 Ethunandan M, Cole R, Flood TR. Corlett loop for microvascular reconstruction in a neck depleted of vessels. Br J Oral Maxillofac Surg 2007; 45 (06) 493-495