Affiliation:
1. Department of Plastic and Reconstructive Surgery Faculty of Medicine and Graduate School of Medicine, Hokkaido University Sapporo Japan
2. Department of Plastic and Reconstructive Surgery Kushiro City General Hospital Kushiro Japan
3. Department of Otolaryngology‐Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine Hokkaido University Sapporo Japan
4. Department of Otolaryngology‐Head and Neck Surgery Kushiro City General Hospital Kushiro Japan
Abstract
ObjectivesExternal color Doppler ultrasonography is reported to be a useful monitoring technique that is simple and noninvasive; however, details of imaging of the transferred free jejunal flap have not been reported. We reviewed our experience using external color Doppler ultrasonography to monitor a transferred free jejunal flap and examined its utility.Study DesignRetrospective study.MethodsSubjects were 43 patients who underwent total pharyngolaryngectomy, reconstruction with a free jejunal flap, and color Doppler ultrasonography before, during, and after surgery between September 2017 and December 2021.ResultsDuring surgery, arterial thrombosis was detected up to 100% with the loss of continuous color signals in the entire circumference. After surgery, the positive predictive value was 100% for each of wiggling movement, dynamic intestinal movement, and continuous color signals in the entire circumference on color Doppler ultrasonography for detecting flap viability. Their negative predictive value was 100%, 7.1%, and 50%, respectively.ConclusionsDuring surgery, the continuous color signals in the entire circumference sign were useful with 100% negative predictive value for detecting the arterial thrombosis. After surgery, the wiggling movement sign very was useful with 100% positive and negative predictive values, enabling salvage surgery to be performed soon after detection of flap failure.Level of Evidence4 Laryngoscope, 133:3361–3369, 2023