Use of the Superior Thyroid Artery as a Recipient Artery in Head and Neck Free Flap Reconstruction: Effects on Post-Operative Hypothyroidism.

Abstract

The superior thyroid artery (STA) as a recipient vessel in free flap reconstruction may theoretically impact thyroid function. This study aimed to assess whether the use of the STA has an adverse effect on thyroid function. Retrospective review of 101 head and neck reconstructive cases. Thyroid function tests were reviewed within 1 year of surgery. The STA was used in 40 cases. The STA cohort had significantly higher TSH levels than the non-STA cohort (7.34 v. 2.87 mU/L, p = 0.02). About 27.5% developed subclinical post-operative hypothyroidism and 17.5% required new levothyroxine supplementation in the STA group. This represents the first study to our knowledge assessing the impact of the STA as a recipient vessel on postoperative thyroid function. While we found a statistically significant difference in average TSH after using the STA, the average TSH/FT4 values were subclinical. Post-operative monitoring for hypothyroidism is warranted in this population.