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Contrast CT‐scan for preoperative planning of VSLN (vascularized submental lymph‐node) transfer
Author(s) -
Mullan Damian,
Kosutic Damir
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24355
Subject(s) - medicine , lymph , lymph node , blood supply , lymphedema , radiology , surgery , cancer , pathology , breast cancer
Background and Objectives Vascularized submental lymph‐node (VSLN) transfer is gaining popularity as a reliable donor‐site in microsurgical treatment of lymphedema. However, variations in number, location, and blood supply to submental lymph‐nodes as well as associate skin‐paddle make a predictable flap harvest a challenging task. We analyzed this region on preoperative imaging, to improve accuracy of VSLN transfers. Methods Contrast CT‐scan analysis of VSLN‐flap areas was performed in 58 patients. Number and location of visibly vascularized lymph nodes as well as submental artery perforators were identified, documented, and compared. Results About 409 lymph‐nodes were found in 50 patients. No significant difference was found in the number of nodes between the right and left side. Significantly more lymph‐nodes were found in zones 1B than zones 1A. In eight patients nodes were not identified. In the remaining 50 patients position of the visibly vascularized submental lymph‐node was predictable. Conclusion Significantly less lymph‐nodes can be found in zone 1a then zone 1b. Location of visibly vascularized lymph nodes can be identified predictably in relation to bony landmarks. Blood supply to 1a nodes and particularly location of dominant skin perforator is unpredictable due to potential crossover. Contrast CT scan can help identify location and blood supply to submental lymph‐nodes in most patients. J. Surg. Oncol. 2017;115:23–26 . © 2016 Wiley Periodicals, Inc.