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Color duplex ultrasonography versus handheld Doppler to plan anterior lateral thigh flaps
Author(s) -
Lethaus Bernd,
Loberg Christina,
KlossBrandstätter Anita,
Bartella Alexander K.,
Steiner Timm,
Modabber Ali,
Hölzle Frank,
Teichmann Jan
Publication year - 2017
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.30177
Subject(s) - medicine , thigh , duplex ultrasonography , head and neck , surgery , head and neck cancer , nuclear medicine , doppler effect , radiology , ultrasonography , radiation therapy , physics , astronomy
Background The anterior lateral thigh flap (ALT) has become increasingly important in reconstructive surgery in the head and neck region. To cope with the problem of anatomical variability in the supplying blood vessels, preoperative evaluation is desirable. Purpose of the study is to compare the most commonly used Doppler devices Handheld Doppler (HD) and Color Doppler Ultrasonography (CDU) for their clinical reliability. Methods Forty five consecutive head and neck cancer patients (mean age 66.0 ± 11.2 years) were included in the study. They all underwent a reconstruction via ALT flap for a defect in the head and neck area. Study period ranged from May 2014 to August 2015. We preoperatively conducted HD and CDU on the lateral thigh and compared the intraoperative findings by measuring presence of the perforator and distance to the estimated position. Results There were 95 perforators identified in 45 patients. The sensitivity and positive predictive value (PPV) were calculated as 97.9% and 100% for CDU and 90.5% and 80.4% for HD, respectively. Accuracy was significantly greater with the HD compared to the CDU device ( P < 0.001) and was strongly associated with body mass index (BMI) ( P < 0.001). This effect was stronger in HD than in CDU ( r = 0.800; P < 0.001 versus r = 0.673; P < 0.001). Conclusions Our results indicate CDU is more precise and reliable than HD with respect to detecting the anatomical position of perforating arteries. © 2017 Wiley Periodicals, Inc. Microsurgery 37:388–393, 2017.