Noninvasive intraoperative angiography for reconstruction of head and neck defects

Shiva Daram, Justin M. Sacks, Michael E. Kupferman

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Reconstruction of head and neck defects after cancer resection involves the use of local, pedicled musculocutaneous, and free flaps. Flap failure is often caused by vascular insufficiency, and it is associated with the presence of cardiovascular or peripheral vascular disease, a history of smoking, and previous radiation and/or surgery. Failure rates may be reduced by the use of indocyanine green near-infrared fluorescence laser angiography, which detects perfusion deficits intraoperatively. Although this technology has been validated in other fields, there is limited experience in the head and neck region. We present 3 cases in which different head and neck flaps were used along with this technology in patients at high risk for flap failure. All flaps were successfully implanted without perioperative or long-term complications. The increasing complexity, age, and comorbidities of the head and neck cancer population pose significant reconstructive challenges. This report demonstrates the feasibility of employing intraoperative angiography for local, pedicled, and free flaps. This noninvasive tool optimizes intraoperative planning and assesses viability, potentially lowering failure rates in high-risk patients. Identification of patients who most benefit from this technology warrants further investigation.

Original languageEnglish (US)
Pages (from-to)E32
JournalEar, Nose and Throat Journal
Volume94
Issue number10-11
StatePublished - Oct 1 2015
Externally publishedYes

Fingerprint

Angiography
Surgical Flaps
Neck
Free Tissue Flaps
Head
Technology
Myocutaneous Flap
Indocyanine Green
Peripheral Vascular Diseases
Fluorescein Angiography
Head and Neck Neoplasms
Blood Vessels
Comorbidity
Lasers
Perfusion
Smoking
Radiation
Population
Neoplasms

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Noninvasive intraoperative angiography for reconstruction of head and neck defects. / Daram, Shiva; Sacks, Justin M.; Kupferman, Michael E.

In: Ear, Nose and Throat Journal, Vol. 94, No. 10-11, 01.10.2015, p. E32.

Research output: Contribution to journalArticle

Daram, Shiva ; Sacks, Justin M. ; Kupferman, Michael E. / Noninvasive intraoperative angiography for reconstruction of head and neck defects. In: Ear, Nose and Throat Journal. 2015 ; Vol. 94, No. 10-11. pp. E32.
@article{8d1f559e1bbd4fc48fcbafe6d1ebd0a6,
title = "Noninvasive intraoperative angiography for reconstruction of head and neck defects",
abstract = "Reconstruction of head and neck defects after cancer resection involves the use of local, pedicled musculocutaneous, and free flaps. Flap failure is often caused by vascular insufficiency, and it is associated with the presence of cardiovascular or peripheral vascular disease, a history of smoking, and previous radiation and/or surgery. Failure rates may be reduced by the use of indocyanine green near-infrared fluorescence laser angiography, which detects perfusion deficits intraoperatively. Although this technology has been validated in other fields, there is limited experience in the head and neck region. We present 3 cases in which different head and neck flaps were used along with this technology in patients at high risk for flap failure. All flaps were successfully implanted without perioperative or long-term complications. The increasing complexity, age, and comorbidities of the head and neck cancer population pose significant reconstructive challenges. This report demonstrates the feasibility of employing intraoperative angiography for local, pedicled, and free flaps. This noninvasive tool optimizes intraoperative planning and assesses viability, potentially lowering failure rates in high-risk patients. Identification of patients who most benefit from this technology warrants further investigation.",
author = "Shiva Daram and Sacks, {Justin M.} and Kupferman, {Michael E.}",
year = "2015",
month = "10",
day = "1",
language = "English (US)",
volume = "94",
pages = "E32",
journal = "Ear, Nose and Throat Journal",
issn = "0145-5613",
publisher = "Medquest Communications LLC",
number = "10-11",

}

TY - JOUR

T1 - Noninvasive intraoperative angiography for reconstruction of head and neck defects

AU - Daram, Shiva

AU - Sacks, Justin M.

AU - Kupferman, Michael E.

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Reconstruction of head and neck defects after cancer resection involves the use of local, pedicled musculocutaneous, and free flaps. Flap failure is often caused by vascular insufficiency, and it is associated with the presence of cardiovascular or peripheral vascular disease, a history of smoking, and previous radiation and/or surgery. Failure rates may be reduced by the use of indocyanine green near-infrared fluorescence laser angiography, which detects perfusion deficits intraoperatively. Although this technology has been validated in other fields, there is limited experience in the head and neck region. We present 3 cases in which different head and neck flaps were used along with this technology in patients at high risk for flap failure. All flaps were successfully implanted without perioperative or long-term complications. The increasing complexity, age, and comorbidities of the head and neck cancer population pose significant reconstructive challenges. This report demonstrates the feasibility of employing intraoperative angiography for local, pedicled, and free flaps. This noninvasive tool optimizes intraoperative planning and assesses viability, potentially lowering failure rates in high-risk patients. Identification of patients who most benefit from this technology warrants further investigation.

AB - Reconstruction of head and neck defects after cancer resection involves the use of local, pedicled musculocutaneous, and free flaps. Flap failure is often caused by vascular insufficiency, and it is associated with the presence of cardiovascular or peripheral vascular disease, a history of smoking, and previous radiation and/or surgery. Failure rates may be reduced by the use of indocyanine green near-infrared fluorescence laser angiography, which detects perfusion deficits intraoperatively. Although this technology has been validated in other fields, there is limited experience in the head and neck region. We present 3 cases in which different head and neck flaps were used along with this technology in patients at high risk for flap failure. All flaps were successfully implanted without perioperative or long-term complications. The increasing complexity, age, and comorbidities of the head and neck cancer population pose significant reconstructive challenges. This report demonstrates the feasibility of employing intraoperative angiography for local, pedicled, and free flaps. This noninvasive tool optimizes intraoperative planning and assesses viability, potentially lowering failure rates in high-risk patients. Identification of patients who most benefit from this technology warrants further investigation.

UR - http://www.scopus.com/inward/record.url?scp=85017043728&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85017043728&partnerID=8YFLogxK

M3 - Article

VL - 94

SP - E32

JO - Ear, Nose and Throat Journal

JF - Ear, Nose and Throat Journal

SN - 0145-5613

IS - 10-11

ER -