title: Volumetric changes of the anterolateral thigh free flap following adjuvant radiotherapy in total parotidectomy reconstruction.
abstract: OBJECTIVE
  The aim of this study was to prospectively evaluate volume change in anterolateral thigh free flaps pre- and postradiotherapy and to compare computed tomography (CT) volumetric analysis with intraoperative water displacement calculation.
  
  
  METHODS
  Matched pair cohort study.
  
  
  METHODS
  Thirteen patients with advanced carcinoma of the parotid gland underwent anterolateral thigh free flap reconstruction following total parotidectomy resections and neck dissection. Before the initiation of external beam radiation, routine CT planning scans were done on all patients. A minimum of 6 months after surgery, a CT scan of the head and neck was carried out, and a detailed volumetric assessment was performed.
  
  
  RESULTS
  The mean preradiotherapy flap volume was 94.3 mL, and the postradiotherapy volume was 84.8 mL. The mean volume reduction in all 13 patients was 8.12%.
  
  
  CONCLUSIONS
  In this prospective study we observed an 8% volume loss in anterolateral thigh free flaps 6 months postradiotherapy. This loss of volume should be taken into account when reconstructing large defects of the face and lateral skull base. Intraoperative water displacement measurement is a useful adjunctive tool for shaping free tissue transfers that are to be used for volume replacement and soft-tissue fill-in.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Science Centre, Toronto, Ontario, Canada. kevin.higgins@sunnybrook.ca
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Higgins
authors.forename: Boban M
authors.initials: BM
authors.lastname: Erovic
authors.forename: Ananth
authors.initials: A
authors.lastname: Ravi
authors.forename: Robert
authors.initials: R
authors.lastname: Yeung
authors.forename: Justin W
authors.initials: JW
authors.lastname: Lee
authors.forename: Christopher
authors.initials: C
authors.lastname: Yao
authors.forename: Danny J
authors.initials: DJ
authors.lastname: Enepekides
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D010306:Parotid Gland / Q000601:surgery*; D010307:Parotid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures / Q000379:methods*; D013848:Thigh / Q000601:surgery*