Revisiting the Transverse Cervical Artery and Vein for Complex Head and Neck Reconstruction
Bibliographic record
Abstract
Background Chemoradiotherapy is the primary treatment modality for glottic and pharyngeal subsites. Management of recurrence or second primaries in this setting is a surgical challenge requiring complex free flap reconstruction. One of the major barriers to effective reconstruction is the availability of suitable recipient vessels. We propose that the transverse cervical artery (TCA) is a viable option for complex head and neck reconstruction. Methods A retrospective chart review of 230 consecutive free tissue reconstructive cases was performed by the senior author (EG). Results Forty cases were identified that used the TCA for arterial anastomosis. Twenty-six patients had prior treatment, 13 of which had multimodality treatment. There were no microvasculature free flap failures and 5 minor flap complications. Conclusions Our experience with the TCA suggests it is a viable option for complex head and neck reconstruction, particularly in the setting of prior comprehensive neck dissection or radiation. In addition, the location of the TCA provides favorable pedicle geometry for microvascular anastomosis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".