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Article

Computed Tomography Angiography (CTA) before Reconstructive Jaw Surgery Using Fibula Free Flap: Retrospective Analysis of Vascular Architecture

by
Michael Knitschke
1,*,
Anna Katrin Baumgart
1,
Christina Bäcker
1,
Christian Adelung
2,
Fritz Roller
2,
Daniel Schmermund
1,
Sebastian Böttger
1,
Hans-Peter Howaldt
1 and
Sameh Attia
1
1
Department of Oral and Maxillofacial Surgery, Justus-Liebig-University, Klinikstrasse 33, 35392 Giessen, Germany
2
Department of Radiology, Justus-Liebig-University, Klinikstrasse 33, 35392 Giessen, Germany
*
Author to whom correspondence should be addressed.
Diagnostics 2021, 11(10), 1865; https://doi.org/10.3390/diagnostics11101865
Submission received: 15 September 2021 / Revised: 6 October 2021 / Accepted: 8 October 2021 / Published: 11 October 2021
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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Abstract

Computed tomography angiography (CTA) is widely used in preoperative evaluation of the lower limbs’ vascular system for virtual surgical planning (VSP) of fibula free flap (FFF) for jaw reconstruction. The present retrospective clinical study analysed n = 72 computed tomography angiographies (CTA) of lower limbs for virtual surgical planning (VSP) for jaw reconstruction. The purpose of the investigation was to evaluate the morphology of the fibular bone and its vascular supply in CTA imaging, and further, the amount and distribution of periosteal branches (PB) and septo-cutaneous perforators (SCPs) of the fibular artery. A total of 144 lower limbs was assessed (mean age: 58.5 ± 15.3 years; 28 females, 38.9%; 44 males, 61.1%). The vascular system was categorized as regular (type I-A to II-C) in 140 cases (97.2%) regarding the classification by Kim. Absent anterior tibial artery (type III-A, n = 2) and posterior tibial artery (type III-B, n = 2) were detected in the left leg. Stenoses were observed mostly in the fibular artery (n = 11), once in the anterior tibial artery, and twice in the posterior tibial artery. In total, n = 361 periosteal branches (PBs) and n = 231 septo-cutaneous perforators (SCPs) were recorded. While a distribution pattern for PBs was separated into two clusters, a more tripartite distribution pattern for SCPs was found. We conclude that conventional CTA for VSP of free fibula flap (FFF) is capable of imaging and distinguishing SCPs and PBs.
Keywords: oral cancer; head and neck tumor; fibula free flap; virtual surgical planning oral cancer; head and neck tumor; fibula free flap; virtual surgical planning

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MDPI and ACS Style

Knitschke, M.; Baumgart, A.K.; Bäcker, C.; Adelung, C.; Roller, F.; Schmermund, D.; Böttger, S.; Howaldt, H.-P.; Attia, S. Computed Tomography Angiography (CTA) before Reconstructive Jaw Surgery Using Fibula Free Flap: Retrospective Analysis of Vascular Architecture. Diagnostics 2021, 11, 1865. https://doi.org/10.3390/diagnostics11101865

AMA Style

Knitschke M, Baumgart AK, Bäcker C, Adelung C, Roller F, Schmermund D, Böttger S, Howaldt H-P, Attia S. Computed Tomography Angiography (CTA) before Reconstructive Jaw Surgery Using Fibula Free Flap: Retrospective Analysis of Vascular Architecture. Diagnostics. 2021; 11(10):1865. https://doi.org/10.3390/diagnostics11101865

Chicago/Turabian Style

Knitschke, Michael, Anna Katrin Baumgart, Christina Bäcker, Christian Adelung, Fritz Roller, Daniel Schmermund, Sebastian Böttger, Hans-Peter Howaldt, and Sameh Attia. 2021. "Computed Tomography Angiography (CTA) before Reconstructive Jaw Surgery Using Fibula Free Flap: Retrospective Analysis of Vascular Architecture" Diagnostics 11, no. 10: 1865. https://doi.org/10.3390/diagnostics11101865

APA Style

Knitschke, M., Baumgart, A. K., Bäcker, C., Adelung, C., Roller, F., Schmermund, D., Böttger, S., Howaldt, H.-P., & Attia, S. (2021). Computed Tomography Angiography (CTA) before Reconstructive Jaw Surgery Using Fibula Free Flap: Retrospective Analysis of Vascular Architecture. Diagnostics, 11(10), 1865. https://doi.org/10.3390/diagnostics11101865

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