2018
DOI: 10.3174/ajnr.a5776
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Imaging of Surgical Free Flaps in Head and Neck Reconstruction

Abstract: Head and neck surgical reconstruction is complex, and postoperative imaging interpretation is challenging. Surgeons now use microvascular free tissue transfer, also known as free flaps, more frequently in head and neck reconstruction than ever before. Thus, an understanding of free flaps, their expected appearance on cross-sectional imaging, and their associated complications (including tumor recurrence) is crucial for the interpreting radiologist. Despite the complexity and increasing frequency of free flap r… Show more

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Cited by 33 publications
(33 citation statements)
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References 33 publications
(41 reference statements)
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“…They mostly occur within 3 months post-surgery, consistent with previously published series, in which the superficial or deep nature of SSI and the existence of osteomyelitis were not stipulated (Durand et al, 2015;Lin et al, 2018). As expected for acute infections, bone abnormalities were not constant on imaging, with a third of patients presenting bone lysis only, but CT scan is also crucial to assess local complications (McCarty et al, 2019). Unfortunately, histopathological analysis was not available for all patients, impeding precise conclusions, but it might play an important role in doubtful cases as for other BJIs (Kapadia et al, 2016;Osmon et al, 2013;ICM, 2022).…”
Section: Discussionsupporting
confidence: 85%
“…They mostly occur within 3 months post-surgery, consistent with previously published series, in which the superficial or deep nature of SSI and the existence of osteomyelitis were not stipulated (Durand et al, 2015;Lin et al, 2018). As expected for acute infections, bone abnormalities were not constant on imaging, with a third of patients presenting bone lysis only, but CT scan is also crucial to assess local complications (McCarty et al, 2019). Unfortunately, histopathological analysis was not available for all patients, impeding precise conclusions, but it might play an important role in doubtful cases as for other BJIs (Kapadia et al, 2016;Osmon et al, 2013;ICM, 2022).…”
Section: Discussionsupporting
confidence: 85%
“…Conversely, large resections with flap reconstructions can be quite complex, and imaging is hampered by metallic hardware. MR is less affected by hardware artifact and more sensitive for recurrent tumor, however, the muscular component of a flap reconstruction will undergo denervation change resulting in variable MR signal intensity and enhancement [22,23]. It is important on the baseline scan following neck reconstruction to ensure there is no residual or progressive tumor, and having knowledge of the pathology report and of positive tumor margins at the time of reconstruction can be very helpful in this regard.…”
Section: Baseline and Surveillance Imaging Of Hn Sccmentioning
confidence: 99%
“…Su indicación principal es la reconstrucción de mamaria. Sin embargo, tiene utilidad para cubrir defectos en la cabeza y el cuello, en los miembros inferiores, en el abdomen e incluso en glosectomías 3,36,37 . Se caracteriza por tener un pedículo vascular largo, y dada la localización del tejido donante suele haber baja morbilidad y pocas complicaciones 37 .…”
Section: Colgajo De Arteria Circunfleja Femoral Lateralunclassified
“…Sin embargo, tiene utilidad para cubrir defectos en la cabeza y el cuello, en los miembros inferiores, en el abdomen e incluso en glosectomías 3,36,37 . Se caracteriza por tener un pedículo vascular largo, y dada la localización del tejido donante suele haber baja morbilidad y pocas complicaciones 37 . La correlación entre la marcación de estas perforantes en la tomografía y los hallazgos quirúrgicos es alta, hasta del 100% según algunos autores 8,38 .…”
Section: Colgajo De Arteria Circunfleja Femoral Lateralunclassified