Background: The veno-accompanying artery adipofascial (VAF) flap is nourished by accompanying vessels near large superficial veins. We examined whether the VAF flap can be applied to the external jugular vein. Methods: Based on anatomic and angiographic studies, we performed reconstructive surgeries using external jugular veno-accompanying artery adipofascial (EJ-VAF) flaps. A retrospective chart review was performed for all patients who underwent this surgery. Results: The presence of arteries accompanying the external jugular vein was confirmed. The presence of source arteries was also confirmed. These included the occipital, facial, and superior thyroid arteries. All patients had satisfactory outcomes, except for 1 patient who had partial necrosis, which was managed using conservative treatment. Conclusion: Our anatomic and angiographic studies in this clinical series indicate that the EJ-VAF flap is a reliable and convenient flap. Thus, it is useful in reconstruction of small to medium head and neck defects.
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