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

Kaitlynne Y Pak; Alberto Nunez; Harsh Patel; Allen S Ho; Jon Mallen-St Clair

doi:10.1002/hed.28049

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

Head Neck. 2025 Jan 5. doi: 10.1002/hed.28049. Online ahead of print.

Authors

Kaitlynne Y Pak¹, Alberto Nunez¹, Harsh Patel², Allen S Ho^{1

3}, Jon Mallen-St Clair^{1

3}

Affiliations

¹ Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cedars Sinai Medical Center, Los Angeles, California, USA.
² Division of Plastic and Reconstructive Surgery, UCLA Medical Center, Los Angeles, California, USA.
³ Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.

PMID: 39757513
DOI: 10.1002/hed.28049

Abstract

Background: 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.

Methods: Retrospective review of 101 head and neck reconstructive cases. Thyroid function tests were reviewed within 1 year of surgery.

Results: 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.

Conclusion: 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.

Keywords: free flap reconstruction; hypothyroidism; superior thyroid artery.