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Imaging the Postoperative Neck

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Atlas of Postsurgical Neuroradiology

Abstract

Flap reconstruction is routinely performed for closing defects created by head and neck tumor resection. Many donor sites and types of flaps are available (Figs. 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.8, and 9.9 and Table 9.1). The imaging features of the flaps depend on their composition and nature of the defect. The denervated muscle components of myocutaneous flaps may demonstrate contrast enhancement and high T2 signal on MRI. Tumor recurrence is perhaps the most significant complication associated with flap reconstruction and most commonly occurs at the site of anastomosis. Recurrence can be difficult to discern due to the altered anatomy of the surgical bed. PET/CT can be helpful in such instances. Other complications of reconstructive flaps include necrosis, fistula formation, hematoma, infection, and instability for bone flaps. These are often clinically apparent. In addition, patients may develop hypertrichosis on the skin surface of myocutaneous flaps, which is particularly problematic in neopharynx reconstruction. The risk of this complication is generally lower with radial forearm free flaps than with pectoral flaps, for instance.

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Further Reading

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Authors and Affiliations

  1. Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA

    Daniel Thomas Ginat M.D., M.S.

  2. Department of Radiology, Harvard Medical School, Boston, MA, USA

    Hugh D. Curtin M.D.

  3. Department of Radiology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA

    Hugh D. Curtin M.D.

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  1. Daniel Thomas Ginat M.D., M.S.
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Correspondence to Daniel Thomas Ginat M.D., M.S. .

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Ginat, D.T., Curtin, H.D. (2012). Imaging the Postoperative Neck. In: Atlas of Postsurgical Neuroradiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-15828-5_9

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