Preoperative vascular imaging for the fibular osteocutaneous flap
W. R. Carroll and R. Esclamado
Bozeman Otolaryngology Associates, Montana, USA.
The fibular osteocutaneous free flap has become a well-accepted method of
mandibular reconstruction. Aberrations in the blood supply to the foot
affect 5% to 7% of the population, and substantial atherosclerotic disease
of the lower extremities is often found in elderly individuals, many of
whom have been smokers. Therefore, the use of preoperative vascular imaging
is justified in all patients scheduled for fibular osteocutaneous free-flap
harvest. In a series of 25 consecutive patients clinically judged to be
satisfactory candidates for fibular free-flap reconstruction, preoperative
arteriograms excluded 4 patients from use of this donor site and determined
which leg was used in 2 other patients.
