Head and neck microsurgical reconstruction using the superficial temporal vein for antegrade and retrograde drainage: A clinical case series

  • M. DayaEmail author
  • T. Pillay
Original Paper



In head and neck microsurgical reconstruction, previous surgery and past radiation exposure to the neck may adversely affect recipient vessel access in the neck. The superficial temporal vessels can be used to overcome these challenges. The purpose of this article is to demonstrate the viability of using the superficial temporal vein (STV) for a double venous anastomosis, for antegrade and retrograde drainage, in head and neck microvascular free flap transfers.


An 11-year retrospective chart review was performed of clinical cases of head and neck reconstruction by free tissue transfer, in which the recipient vessels used were the superficial temporal artery (STA) and vein, with the latter providing for dual antegrade and retrograde drainage.


The case series comprised of six patients who underwent free flap reconstruction of craniofacial defects following resection of malignant tumours in five, and due to noma in one. Compromising factors were scarring, radiotherapy, previous surgery and the recipient superficial temporal vein being less than 1 mm in diameter above the parotid. The recipient vessels used were the superficial temporal artery and veins in all cases.


The use of the superficial temporal blood supply for a single arterial supply and a dual antegrade and retrograde venous drainage is a reliable technique for free flaps to the upper two thirds of the head. A double venous anastomosis adds to its dependability.

Level of Evidence: Level IV, therapeutic study.


Retrograde and antegrade superficial temporal venous drainage Double venous anastomosis Scalp and cheek microsurgical reconstruction Large scalp defect Vessel-depleted neck Previous radiotherapy to neck 



We would like to extend our gratitude to MR Warwick Morris for assisting us with the language editing. Both authors contributed equally to the study.

Compliance with ethical standards

Ethical approval

Approval number BE 291/13 was obtained from the university’s Biomedical Research Ethics committee.

Conflict of interest

M. Daya and T. Pillay have no financial disclosures and report no conflicts of interest with any of the companies or products mentioned in this article.

Patient consent

Patients provided written consent for their inclusion in this study. Additional consent was obtained for the use of patient’s images.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Plastic and Reconstructive Surgery, Nelson R Mandela School of MedicineUniversity of Kwazulu-NatalDurbanSouth Africa
  2. 2.Department of Plastic and Reconstructive SurgeryInkhosi Albert Luthuli Central HospitalDurbanSouth Africa

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