Comparing Free-Flap Reconstruction After Robot-Assisted Neck Dissection via a Retroauricular Approach and a Traditional Transcervical Approach: Single-Surgeon Experiences of 90 Consecutive Cases

Kim, Hyounmin; Cha, In‐Ho; Kim, Hyung Jun; Nam, Woong; Yang, Han-Chul; Cho, Sung-Uk; Koh, Yoon Woo; Kim, Dong-Wook

doi:10.1245/s10434-022-12904-3

Cited by 2 publications

(1 citation statement)

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“…Using the number of CT slides to estimate pedicle length is primitive, but it is a simple way to intuitively estimate length. The information obtained in this way can be useful when preoperatively predicting the length of the vascular pedicle such as in free flap reconstructions of the maxilla or after robot-assisted retroauricular neck dissection, where a longer vascular pedicle is needed compared to the tongue, mandible, pharynx, or conventional transcervical approaches [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Perforators Detected in Computed Tomography Angiography for Anterolateral Thigh Free Flap: Am I the Only One Who Feels Inaccurate?

Kim

Cha

Kim

et al. 2023

JCM

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Background: The number, location, and pattern of perforators in anterolateral thigh(ALT) flap vary and predicting them preoperatively will aid in reconstructing complex head and neck defects. This article suggests guidelines for utilizing CTA imagery to predict perforators of ALT-free flaps. Methods: We retrospectively analyzed 53 Korean patients who underwent reconstruction with ALT flap in our department from March 2021 to July 2022. The location, course, origin, and pedicle lengths predicted in CTA and confirmed in the operation field were recorded and compared. Results: Among the 85 intraoperatively-found perforators, 79 were also identified in CTA. Six perforators unidentified in CTA were newly found intraoperatively. The positive predictive value of CTA for the perforator was 100%, with a sensitivity of 79/85 = 92.9%. Of the 79 perforators depicted by the CTA for the flap, CTA and intraoperative findings for the course were consistent in 52 cases, a 9.6 mm median discrepancy being noted between the actual location and CTA. Conclusions: The overall pattern or location of perforation was not significantly different between the two, although some differences were observed. It is suggested that the addition of Doppler imaging, in conjunction with CTA, can aid in perforator detection and help minimize such discrepancies.

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Section: Discussionmentioning

confidence: 99%