title: [Implantable doppler probe for microsurgical free flap monitoring in cervico-facial reconstructive surgery].
abstract: OBJECTIVE
  The use of free flaps in head and neck reconstructive surgery requires postoperative monitoring, usually by conventional clinical tests. Nevertheless, clinical testing is not applicable to buried free flaps that are more frequently used in the head and neck area. The purpose of this study was to describe the use and to evaluate the implantable doppler system in this setting.
  
  
  METHODS
  Among 162 patients who underwent free flap reconstruction in our department, between June 2008 and October 2012, 23 patients had postoperative monitoring using implantable doppler system. Probe placement, monitoring parameters and postoperative course was analyzed.
  
  
  RESULTS
  Our series included 15 forearm free flaps, seven fibular flaps and one scapular flap. Indications for reconstruction were following the removal of a malignant tumor in 18 cases, a benign tumor in two cases and an osteoradionecrosis in three cases. Free flap monitoring by conventional clinical tests was not possible in 19 patients. Doppler signal was detected continuously during seven days in 82% of cases. A loss of signal was observed in three cases. Surgical exploration was required in one patient.
  
  
  CONCLUSIONS
  Implantable doppler for free flap monitoring is a safe, reliable and efficient technique and cost is reasonable. The use of implantable doppler system seems particularly useful in head and neck reconstruction for buried free flaps, which are not accessible to conventional clinical tests.
authors: Service de chirurgie ORL et cervico-faciale, hôpital Bichat, GHU Paris Nord - Val de Seine, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France.
authors: V
authors: V
authors: Clert
authors: C
authors: C
authors: Guédon
authors: J-P
authors: JP
authors: Cristofari
authors: C
authors: C
authors: Halimi
authors: B
authors: B
authors: Barry
authors: S
authors: S
authors: Albert
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D019651:Plastic Surgery Procedures / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000295:instrumentation*