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Intraoperative Ultrasound in Spinal Surgery
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Intraoperative imaging during head and neck reconstruction.

Whitney Jin1, Wenda Ye, Michael C Topf

  • 1Vanderbilt University Medical Center Department of Otolaryngology- Head and Neck Surgery, Nashville, Tennessee, USA.

Current Opinion in Otolaryngology & Head and Neck Surgery
|August 21, 2025
PubMed
Summary

Intraoperative imaging enhances head and neck reconstruction safety and precision. Techniques like indocyanine green fluorescence angiography (ICG) and navigation systems improve flap viability, bony alignment, and surgical education.

Keywords:
bony reconstructionhead and neck reconstructionindocyanine green fluorescence angiographyintraoperative imagingperfusion assessment

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Area of Science:

  • Surgical Oncology
  • Head and Neck Surgery
  • Medical Imaging

Background:

  • Head and neck reconstruction involves complex procedures requiring precise imaging.
  • Traditional methods may lack real-time feedback for critical surgical decisions.

Purpose of the Study:

  • To review current intraoperative imaging techniques in head and neck reconstruction.
  • Focus on vascular perfusion, bony reconstruction, and visualization/education.

Main Methods:

  • Review of recent technological advances and implementation of imaging in head and neck reconstruction.
  • Analysis of techniques including indocyanine green fluorescence angiography (ICG), intraoperative CT, navigation systems, and exoscope systems.

Main Results:

  • Indocyanine green fluorescence angiography (ICG) adoption for real-time flap perfusion assessment improves viability.
  • Intraoperative CT and navigation systems enhance precision in bony reconstruction and hardware placement.
  • Exoscope systems improve intraoperative visualization, planning, and surgical education.

Conclusions:

  • Intraoperative imaging advances safety and precision in head and neck reconstruction.
  • ICG, navigation, and augmented visualization tools aid decision-making, reduce complications, and enhance education.
  • Further research needed for protocol standardization and wider technology implementation.