Abstract:

Objective

To investigate the value of preoperative high-frequency ultrasonography （HFUS） in selection and design of vascularized myocutaneous flaps.

Methods

In 116 cases， 137 axial arteries were detected with HFUS preoperatively. The diameters， plaque sizes and stenosis rates of arteries were measured. The origination， course and location of the arteries were marked on the skin of the patients and compared with the intra-operative findings.The survival of the flaps was followed up post-operatively.

Results

Right transverse cervical artery（TCA） was detected to be absent in one patient. The other 137 axial arteries out of 116 cases were demonstrated by HFUS successfully. In 17 out of 137 axial arteries， vascular sclerosis and/or stenosis were found （17/137，12.4%）. The minimal diameter of artery was only 0.5 mm and the maximal stenosis rate was about 50%. Myocutaneous flaps were used in 113 patients （except 3），including 9 alternative myocutaneous flaps （9/113，7.96%）. The origination， course and location of the arteries marked preoperatively on 113 patients' body surface were almost exactly matched the intra-operative findings. During 2 ～36 months' follow-up， myocutaneous flaps in 110 cases（110/113，97.3%） survived well. However， partial necrosis occurred in two myocutaneous flaps（2/113，1.77%） and compete necrosis occurred in one （1/113，0.89%）.

Conclusions

With HFUS， the axial arteries can be accurately assessed and exactly marked on the surface of the patients. It is suggested that HFUS is useful in the selection and design of vascularized myocutaneous flaps for the reconstruction of oromaxillo-facial defects.

Key words: High-frequency ultrasound, Vascularized myocutaneous flap, Axial artery, Oral and maxillofacial surgery