Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Value of the Post-Operative CT in Predicting Delayed Flap Failures Following Head and Neck Cancer Surgery

  • Kim, Bitna (Department of Radiology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Yoon, Dae Young (Department of Radiology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Seo, Young Lan (Department of Radiology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Park, Min Woo (Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial Institute of Head and Neck Cancer, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Kwon, Kee Hwan (Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial Institute of Head and Neck Cancer, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Rho, Young-Soo (Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial Institute of Head and Neck Cancer, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Chung, Chul Hoon (Department of Plastic Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine)
  • Received : 2016.08.22
  • Accepted : 2016.11.11
  • Published : 2017.06.01
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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.

Keywords

References

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