Researchers evaluating extracervical options in maxillofacial surgery report that superficial temporal vessels achieved a 94.4% flap survival rate in a 20-patient retrospective cohort study published on October 29, 2026. The approach offers a viable alternative when traditional neck vessels are unsuitable.
Reconstructing complex defects in the head and neck region routinely tests the limits of microsurgery. When primary neck vessels are unavailable, depleted by prior treatment, or otherwise unsuitable, surgical teams must look elsewhere for reliable blood supply. Recent clinical data from a single-center cohort evaluation highlight the superficial temporal system as a practical extracervical recipient site for these challenging maxillofacial reconstructions.
Clinical Outcomes and Patient Cohort at Klinikum Dortmund
The retrospective evaluation conducted at the Department of Oral and Maxillofacial Surgery at Klinikum Dortmund in Dortmund, Germany, analyzed 20 consecutive patients treated between January 2019 and December 2025. Data collection concluded on June 30, 2026, ensuring every participant maintained a minimum postoperative follow-up of six months.
During these procedures, the superficial temporal artery was successfully utilized in 18 out of the 20 patients, representing a 90% success rate for arterial selection. Venous drainage proved achievable through the superficial temporal vein in 17 of those 18 successful cases, or 94.4%. When surgical teams confirmed adequate arterial diameter and strong pulsatile flow, they performed an end-to-end microvascular anastomosis using 9-0 or 10-0 nylon sutures without relying on a coupler device. In a single instance, the arterial inflow was paired with the internal jugular vein to secure proper venous return.
Sequential Microvascular Tissue Transfer for Radiation-Induced Sequelae
A separate retrospective observational study examined a different subset of patients facing severe complications after primary treatment. Conducted between June 2024 and December 2025 at a tertiary referral center, this research evaluated sequential microvascular free tissue transfer for individuals who previously underwent primary mandibular reconstruction using a fibula free flap followed by adjuvant radiotherapy.
Those patients later developed delayed radiation-induced damage, most notably hardware exposure combined with soft tissue volume loss. Out of the ten patients included in this specific study, all had previously undergone segmental mandibulectomy and subsequent radiation therapy. Researchers noted that the duration separating the completion of adjuvant therapy and the secondary corrective surgery ranged from 7 to 60 months.
Vessel Selection and Surgical Adaptations in Irradiated Fields
Operating within a previously irradiated neck introduces significant hostility for a surgical team, including fibrotic tissue and depleted vascular beds. To bypass these compromised zones, investigators in the sequential transfer study utilized the superficial temporal vessels as recipient sites in all ten cases.
Similarly, the Dortmund cohort demonstrated that exploring the superficial temporal fascia allows surgeons to locate alternative venous branches when the primary superficial temporal vein lacks sufficient caliber or flow.
| Study Focus | Setting and Timeframe | Cohort Size | Key Finding |
|---|---|---|---|
| Superficial Temporal Vessels as Recipient Sites | Klinikum Dortmund, Germany (Jan 2019 – Dec 2025) | 20 patients | 94.4% overall flap survival with 90% arterial success |
| Sequential Microvascular Tissue Transfer | Tertiary referral center (June 2024 – Dec 2025) | 10 patients | Use of superficial temporal vessels as recipient sites |
Addressing Long-Term Healing Objectives
Complications from radiation therapy extend beyond hardware exposure and surface contour deformities. By combining hardware removal with sequential soft tissue reconstruction in a single operative setting, surgical teams addressed both plate exposure and underlying volume deficits.