title: Quantitative analysis of free flap volume changes in head and neck reconstruction.
abstract: BACKGROUND
  The purpose of this study was to determine whether free flap volume decreases or increases in the long-term postoperative period.
  
  
  METHODS
  We used a retrospective analysis of 17 patients to measure muscle and fat volume in free flap with 3-dimensional (3D) images using the AZE Virtual Place Lexus64.
  
  
  RESULTS
  Seventeen patients underwent free flap reconstruction with rectus abdominis musculocutaneous flaps (n = 11) or anterolateral thigh flaps (n = 6). Median follow-up was 28.9 months (range, 2.1-48.4 months). Total flap volume was significantly decreased in flaps including ≥40% muscle (p = .011). Mean final muscle volume was 50% at an average of 12 months. Final fat volume was significantly higher for cases with no evidence of disease (mean, 116.7%) than for died-of-the-disease cases (mean, 70.3%; p = .007).
  
  
  CONCLUSIONS
  Use of free flaps with a high ratio of fat to muscle is sustainable and can gain volume over time, as transplanted fat can increase depending on host condition.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata, Okayama 700-8558, Japan. kuru3641@gmail.com
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kimata
authors.forename: Satoshi
authors.initials: S
authors.lastname: Onoda
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Mizukawa
authors.forename: Tomoo
authors.initials: T
authors.lastname: Onoda
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000098:blood supply* / Q000473:pathology*; D006085:Graft Survival; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D017568:Rectus Abdominis / Q000000981:diagnostic imaging / Q000473:pathology / Q000637:transplantation; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013848:Thigh / Q000000981:diagnostic imaging / Q000601:surgery