[Application of CT angiography in design of anterolateral thigh perforator flap for reconstruction of defect after head and neck cancer resection].

OBJECTIVE

To evaluate the benefits of CT angiography (CTA) in preoperative mapping of anterolateral thigh perforator flap (ALTPF) for reconstruction of defect after head and neck cancer resection.

METHODS

Twenty-four patients underwent reconstruction of postoperative defect with ALTPF from March 2011 to March 2014 were retrospectively reviewed. According to the imaging methods used for examining perforating artery, these patients were divided into two groups: color Doppler flow imaging (CDFI)-group and CTA-group, 12 patients in each group. The surgical results of all patients were evaluated for consistency in number of perforating artery, operation time and flap-related complications.

RESULTS

Only one of all patients had complete flap necrosis, with an overall flap survival rate of 95.83%. All perforating branches showed with preoperative CTA were found in operation (12/12), significantly higher than CDFI-group (8/12). The mean operation time of CTA-group was significantly shorter than that of CDFI-group (Unilateral neck dissection: (6.80±0.53) vs (8.39±0.75) h, bilateral neck dissection: (8.79±0.97) vs (10.96±0.26) h, both P<0.05). Flap-related complication occurred in one case in CTA-group, but in 5 cases in CDFI-group.

CONCLUSIONS

CTA can accurately provide anatomical information of perforator vessels and guide preoperative design of ALTPF to improve operative outcomes, including the decrease in operation time and surgical injury.