Early postoperative bone scintigraphy in the evaluation of microvascular bone grafts in head and neck reconstruction.
BACKGROUND
Bone scintigraphy was performed to monitor anastomotic patency and bone viability.


METHODS
In this retrospective study, bone scans were carried out during the first three postoperative days in a series of 60 patients who underwent microvascular bone grafting for reconstruction of the mandible or maxilla.


RESULTS
In our series, early bone scans detected a compromised vascular supply to the bone with high accuracy (p < 10-6) and a sensitivity that was superior to the sensitivity of clinical monitoring (92% and 75% respectively).


CONCLUSIONS
When performing bone scintigraphy during the first three postoperative days, it not only helps to detect complications with high accuracy, as described in earlier studies, but it is also an additional reliable monitoring tool to decide whether or not microvascular revision surgery should be performed. Bone scans were especially useful in buried free flaps where early postoperative monitoring depended exclusively on scans. According to our experience, we recommend bone scans as soon as possible after surgery and immediately in cases suspicious of vascularized bone graft failure.
Schuepbach
Jonas
J
Department of Otolaryngology, Head and neck surgery, University Hospital Inselspital Berne, Freiburgstrasse, Berne, Switzerland. jonas.schuepbach@insel.ch
Dassonville
Olivier
O
Poissonnet
Gilles
G
Demard
Francois
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation / Q000000981:diagnostic imaging* / Q000379:methods*; D044964:Cervicoplasty / Q000379:methods; D005260:Female; D005360:Fibula / Q000098:blood supply / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D016896:Treatment Outcome