{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T04:17:42Z","timestamp":1782793062543,"version":"3.54.5"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:00Z","timestamp":1699488000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe our technique, review indications, and evaluate the outcomes of the minimal access approach for recipient vessel identification in microvascular tissue transfer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective chart review of all patients who underwent microvascular reconstruction using the minimal access technique between 2015 and 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We report 236 cases, comprising 214 patients with a mean age of 60.2\u2009years (3\u201388). The most common primary defect sites were the mandible (22.6%), cranium (14%), maxilla (13.2%), skull base (12.8%), and nose\/nasal cavity (10.6%). Indications for free flap reconstruction included head and neck cancer extirpation (32.2%), osteoradionecrosis (29.7%), acquired deformity (14.0%), chronic wound (11.9%) and oral motor dysfunction (7.2%). Free flap donor sites used were the anterolateral thigh (84.3%), fibula (7.2%), and radial forearm (6.4%). Vessels utilized include superficial temporal (49.8%), facial (38.3%), angular (11.1%), and transverse cervical (0.4%). The overall complication rate was 14% (<jats:italic>n<\/jats:italic>\u2009=\u200933), with surgical complications at the recipient site accounting for 67.6% (<jats:italic>n<\/jats:italic>\u2009=\u200925). Flap failure occurred in 3.4% of procedures. Prior head and neck surgery and free flaps were associated with an increased risk of major recipient site complications (<jats:italic>n<\/jats:italic>\u2009=\u200920, <jats:italic>p<\/jats:italic>\u2009=\u20090.0257 and <jats:italic>n<\/jats:italic>\u2009=\u200914, <jats:italic>p<\/jats:italic>\u2009=\u20090.0117, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Minimal access techniques allow consistent recipient vessel identification for microvascular\u2010free tissue transfer. These approaches may be utilized in reconstructing a broad range of head and neck defects, are low morbidity, and contribute to an overall shorter length of stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2 <jats:italic>Laryngoscope<\/jats:italic>, 134:2177\u20132181, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31168","type":"journal-article","created":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T11:34:00Z","timestamp":1699529640000},"page":"2177-2181","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Minimally Invasive Approach to Access Vessels for Microvascular Anastomosis in Head and Neck Reconstruction"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6196-0652","authenticated-orcid":false,"given":"Derek J.","family":"Vos","sequence":"first","affiliation":[{"name":"Case Western Reserve University School of Medicine  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4336-1776","authenticated-orcid":false,"given":"Khashayar","family":"Arianpour","sequence":"additional","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Fritz","sequence":"additional","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Hadford","sequence":"additional","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7139-1502","authenticated-orcid":false,"given":"Sara W.","family":"Liu","sequence":"additional","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon L.","family":"Prendes","sequence":"additional","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Ciolek","sequence":"additional","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23471"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818757949"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23775"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22212"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2014.875"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25853"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1715644"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004770"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000008856"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25767"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28540"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.410"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200002010-00005"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-012-2224-z"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22270"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.128.3.328"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000002951"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/froh.2022.980786"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199908000-00028"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2015.03.006"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2019.07.006"}],"container-title":["The 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