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KMID : 0880420170180030536
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Korean Journal of Radiology
2017 Volume.18 No. 3 p.536 ~ p.542
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Value of the Post-Operative CT in Predicting Delayed Flap Failures Following Head and Neck Cancer Surgery
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Kim Bit-Na
Yoon Dae-Young
Seo Young-Lan
Park Min-Woo
Kwon Kee-Hwan
Rho Young-Soo
Chung Chul-Hoon
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Abstract
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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.
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KEYWORD
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Head and neck cancer, Post-operative CT, Flap reconstruction, Surgical flaps, Reconstructive surgical procedures, Flap failure, Post-operative period
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