Value of the Post-Operative CT in Predicting Delayed Flap Failures Following Head and Neck Cancer Surgery.
10.3348/kjr.2017.18.3.536
- Author:
Bitna KIM
1
;
Dae Young YOON
;
Young Lan SEO
;
Min Woo PARK
;
Kee Hwan KWON
;
Young Soo RHO
;
Chul Hoon CHUNG
Author Information
1. Department of Radiology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355, Korea. evee0914@chollian.net
- Publication Type:Original Article
- Keywords:
Head and neck cancer;
Post-operative CT;
Flap reconstruction;
Surgical flaps;
Reconstructive surgical procedures;
Flap failure;
Post-operative period
- MeSH:
Fistula;
Head and Neck Neoplasms*;
Head*;
Humans;
Reconstructive Surgical Procedures;
Retrospective Studies;
Skin;
Surgical Flaps;
Tomography, X-Ray Computed
- From:Korean Journal of Radiology
2017;18(3):536-542
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To identify post-operative computed tomography (CT) findings associated with delayed flap failures following head and neck cancer surgery. MATERIALS AND METHODS: We retrospectively reviewed 60 patients who underwent flap reconstruction after head and neck cancer surgery and post-operative (3–14 days) contrast-enhanced CT scans for suspected complications. Patients were divided into two groups: delayed flap failure patients (patients required flap revision) (n = 18) and flap success patients (n = 42). Clinical data (age, sex, T-stage, type of flap, and time interval between reconstruction surgery and CT) and post-operative CT findings of flap status (maximum dimension of the flap, intra- or peri-flap fluid collection and intra- or peri-flap air collection, fat infiltration within the flap, fistula to adjacent aerodigestive tract or skin, and enhanced vascular pedicle) were assessed and compared between the two groups. RESULTS: CT findings showed that the following flap anomalies were observed more frequently in the delayed flap failure group than in the flap success group: intra- or peri-flap fluid collection > 4 cm (61.1% vs. 23.8%, p < 0.05), intra- or peri-flap air collection > 2 cm (61.1% vs. 2.4%, p < 0.001), and fistula to adjacent aerodigestive tract or skin (44.4% vs. 0%, p < 0.001). The maximum dimension of the flap, fat infiltration within the flap, and enhanced vascular pedicle were not associated with delayed flap failures. CONCLUSION: A large amount of fluid or air collection and fistula are the CT findings that were associated with delayed flap failures in patients with suspected post-operative complications after head and neck cancer surgery.
