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Erschienen in:
01.12.2024 | Original Paper
Superficial temporal and occipital arteries in free flap scalp reconstruction: anatomical and radiologic study
Erschienen in: European Journal of Plastic Surgery | Ausgabe 1/2024
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Background
The reconstruction of scalp defects represents a major challenge due to the need for functional and cosmetic coverage. Free flaps are often the preferred approach for managing significant scalp defects, but proper recipient vessel selection is crucial for successful tissue transfer. The scalp is highly vascularised and offers multiple options. Occipital vessels are valuable for anastomosis and less frequently used.
Methods
Superficial temporal and occipital arteries were studied and compared using angio-computed tomography (Angio-CT) scans and ultra-sound Doppler (US-Doppler). Additional exploration was performed with cadaveric dissections. A total of 30 subjects were examined using Angio-CT scan and 32 using US-Doppler, and 11 hemi-faces were dissected.
Results
Respectively, superficial temporal arteries and occipital arteries have a mean diameter of 1.8 mm and 1.5 mm in cadaveric dissections, 1.69 mm and 1.51 mm in Angio-CT scans and 1.38 mm and 1.54 mm in US-Doppler.
Conclusions
Occipital arteries are stable and reliable alternatives for free flap reconstruction of the scalp. Based on these anatomical and radiologic findings, the occipital artery, in its sub-cutaneous segment, can be used as a recipient vessel in scalp reconstruction, in case of flap with a short pedicle, vertex or parieto-occipital defects and especially in complex cases with missing external carotid system.
Level of evidence: Level IV, diagnostic study