Influence of preoperative imaging on fibula free flap harvesting.

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  • Additional Information
    • Source:
      Publisher: Elsevier Masson SAS Country of Publication: France NLM ID: 101701089 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2468-7855 (Electronic) Linking ISSN: 24687855 NLM ISO Abbreviation: J Stomatol Oral Maxillofac Surg
    • Publication Information:
      Original Publication: Issy les Moulineaux Cedex : Elsevier Masson SAS, [2017]-
    • Subject Terms:
      Tissue and Organ Harvesting*/adverse effects ; Tissue and Organ Harvesting*/methods ; Tissue and Organ Harvesting*/standards; Angiography, Digital Subtraction/*methods ; Fibula/*diagnostic imaging ; Fibula/*surgery ; Free Tissue Flaps/*surgery ; Magnetic Resonance Angiography/*methods ; Preoperative Care/*methods; Adult ; Aged ; Female ; Fibula/blood supply ; Fibula/transplantation ; Free Tissue Flaps/blood supply ; Free Tissue Flaps/transplantation ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Plastic Surgery Procedures/methods ; Retrospective Studies ; Treatment Outcome ; Young Adult
    • Abstract:
      Introduction: The fibula free flap (FFF) is the gold standard for the reconstruction of large maxillofacial defects. Magnetic resonance angiography (MRA) seems to supersede digital subtraction angiography (DSA) as the reference in preoperative evaluation, being non-invasive and having equivalent diagnostic results. The aim of this study was to assess the impact of preoperative MRA versus DSA on the viability of FFF and its success rate.
      Material and Methods: A total of 216 patients, who underwent mandibular or maxillary FFF reconstruction from January 1995 to January 2011, were retrospectively included in the study. Of them, 101 patients underwent preoperative DSA and 115 underwent MRA. Recorded criteria were as follows: age, sex, tobacco consumption, defect etiology, preoperative vascular assessment, donor-site choice and flap failure. The DSA group was compared to the MRA group.
      Results: The harvested side was switched in 15.7% of cases with preoperative MRA versus 4% with DSA. Our success rate was higher (96.1%) with MRA than with DSA (88.1%) (P<0.05). More atherosclerotic patients (P=0.004) were diagnosed through MRA. MRA and DSA showed similar results in anatomical variation detection.
      Conclusion: MRA is less invasive and more effective in atherosclerosis detection than DSA. Therefore, donor-site switching was more frequent in the MRA group, which led to a better success rate. MRA should replace DSA as the reference in preoperative assessment.
      (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)
    • Contributed Indexing:
      Keywords: Atherosclerosis detection; DSA; Fibula free flap; MRA; Success rate
    • Publication Date:
      Date Created: 20170523 Date Completed: 20190826 Latest Revision: 20221207
    • Publication Date:
      20221213
    • Accession Number:
      10.1016/j.jormas.2017.05.002
    • Accession Number:
      28529045