Endoscopic measurements of free-flap perfusion in the head and neck region using red-excited Indocyanine Green
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Endoscopic measurements of free-flap perfusion in the head and neck region using red-excited Indocyanine Green : preliminary results. / Betz, C S; Zhorzel, S; Schachenmayr, H; Stepp, H; Havel, M; Siedek, V; Leunig, A; Matthias, C; Hopper, C; Harreus, U.
in: J PLAST RECONSTR AES, Jahrgang 62, Nr. 12, 12.2009, S. 1602-8.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Endoscopic measurements of free-flap perfusion in the head and neck region using red-excited Indocyanine Green
T2 - preliminary results
AU - Betz, C S
AU - Zhorzel, S
AU - Schachenmayr, H
AU - Stepp, H
AU - Havel, M
AU - Siedek, V
AU - Leunig, A
AU - Matthias, C
AU - Hopper, C
AU - Harreus, U
PY - 2009/12
Y1 - 2009/12
N2 - BACKGROUND: Free-tissue transfer has become a standard procedure for reconstructive surgery in the head and neck area. Flap failures are relatively rare (METHODS: So far, 11 patients with free-flap reconstructions of the upper aerodigestive tract (UADT) have participated in this study. Each participant underwent three endoscopic ICG angiographies (24h intra-operatively and 72h postoperatively). The data obtained were evaluated online as well as offline on a personal computer (PC), and the results compared to the clinical outcome.RESULTS: There were no partial or complete flap losses. One flap was successfully salvaged following initial arterial kinking with impeded perfusion. The ICG fluorescence angiography was tolerated well in all patients. The free flaps showed a delayed yet equal ICG fluorescence as compared to the surrounding tissue. The timing and slope of fluorescence build-up were dependent on circulatory factors. The relative fluorescence maxima of flap versus surrounding were 33% in the initially failing flap and >or=64% for all other examinations.CONCLUSIONS: It was possible to prove the feasibility of endoscopic ICG fluorescence angiography in patients undergoing free-flap transfer to the UADT. The method provides instant information about the perfusion state of the tissue and is easily performed without greater patient discomfort or risk of side effects. Due to the endoscopic approach, the method seems highly promising for this indication and merits further evaluation.
AB - BACKGROUND: Free-tissue transfer has become a standard procedure for reconstructive surgery in the head and neck area. Flap failures are relatively rare (METHODS: So far, 11 patients with free-flap reconstructions of the upper aerodigestive tract (UADT) have participated in this study. Each participant underwent three endoscopic ICG angiographies (24h intra-operatively and 72h postoperatively). The data obtained were evaluated online as well as offline on a personal computer (PC), and the results compared to the clinical outcome.RESULTS: There were no partial or complete flap losses. One flap was successfully salvaged following initial arterial kinking with impeded perfusion. The ICG fluorescence angiography was tolerated well in all patients. The free flaps showed a delayed yet equal ICG fluorescence as compared to the surrounding tissue. The timing and slope of fluorescence build-up were dependent on circulatory factors. The relative fluorescence maxima of flap versus surrounding were 33% in the initially failing flap and >or=64% for all other examinations.CONCLUSIONS: It was possible to prove the feasibility of endoscopic ICG fluorescence angiography in patients undergoing free-flap transfer to the UADT. The method provides instant information about the perfusion state of the tissue and is easily performed without greater patient discomfort or risk of side effects. Due to the endoscopic approach, the method seems highly promising for this indication and merits further evaluation.
KW - Aged
KW - Coloring Agents
KW - Endoscopy
KW - Feasibility Studies
KW - Female
KW - Fluorescein Angiography
KW - Graft Rejection
KW - Head and Neck Neoplasms
KW - Humans
KW - Indocyanine Green
KW - Male
KW - Microcirculation
KW - Middle Aged
KW - Postoperative Care
KW - Reconstructive Surgical Procedures
KW - Surgical Flaps
KW - Evaluation Studies
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1016/j.bjps.2008.07.042
DO - 10.1016/j.bjps.2008.07.042
M3 - SCORING: Journal article
C2 - 19036663
VL - 62
SP - 1602
EP - 1608
JO - J PLAST RECONSTR AES
JF - J PLAST RECONSTR AES
SN - 1748-6815
IS - 12
ER -