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Porcine As a Training Module for Head and Neck Microvascular Reconstruction
Published on: September 29, 2018
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Head and neck reconstructive surgery: what the radiologist needs to know.
Faiz Syed1, Matthew E Spector2, Rebecca Cornelius3
1Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
European Radiology
|January 21, 2016
Summary
Microvascular free tissue transfer flaps are common in head and neck cancer reconstruction. Radiologists should understand flap appearance and potential tumor recurrence at flap margins for better patient care.
Area of Science:
- Radiology
- Surgical Oncology
- Plastic Surgery
Background:
- Microvascular free tissue transfer is standard for head and neck cancer reconstruction after ablative surgery.
- Commonly used flaps include radial forearm, anterolateral thigh, and fibula flaps, composed of various tissues like skin, fat, muscle, and bone.
- Adverse outcomes include tumor recurrence, typically at flap margins, and flap necrosis due to vascular thrombosis or infection.
Purpose of the Study:
- To improve radiologists' understanding of flap reconstruction methods in head and neck cancer surgery.
- To familiarize radiologists with the radiographic appearance of common flaps and their components.
- To enhance recognition of flap margins and vascular anastomoses for improved postoperative assessment.
Main Methods:
- Review of common microvascular free tissue transfer flaps used in head and neck reconstruction.
- Analysis of radiographic features based on flap components (skin, fat, muscle, bone).
- Discussion of potential complications, focusing on tumor recurrence at flap margins and flap necrosis.
Main Results:
- The radiographic appearance of flaps is variable, depending on their constituent tissues.
- Tumor recurrence is a significant complication, predominantly observed at the flap margins.
- Flap necrosis can occur due to vascular thrombosis or infection, impacting reconstructive success.
Conclusions:
- Flaps are the primary reconstructive method for neck cancer surgery.
- Imaging findings of flaps are influenced by their composition and the time elapsed since surgery.
- The flap margins represent the most common site for tumor recurrence following reconstruction.
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