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Volume 1 Supplement 1

1st Scientific Meeting of the Head and Neck Optical Diagnostics Society

Endoscopic examinations of free flap perfusion in the head and neck region using red-excited Indocyanine Green

Head & Neck Oncology volume 1, Article number: P29 (2009) Cite this article

Objective

Malfunction of microvascular anastomoses is regarded as the main reason for failure of free tissue transfer. It was the aim of the current investigation to prove the feasibility and to explore the clinical benefit of endoscopically guided free flap perfusion measurements in the head and neck region using red-excited Indocyanine Green (ICG).

Methods

25 patients who underwent reconstructive surgery including free tissue transfer to the head and neck region took part in this study. Each participant underwent 3 ICG-angiographies (intraoperatively, 24 hrs and 72 hrs postoperatively). The obtained data were evaluated online and offline on PC, and the results compared to the clinical outcome.

Results

There were no partial or complete losses of transplants. Two flaps with an early arterial failure were successfully salvaged by revision surgery. The ICG-angiographies were tolerated well. The gain of fluorescence was delayed in the transplanted tissue when compared to the surrounding tissue, whereas the final maximum fluorescence intensities were comparable. The two flaps with the initial compromise in perfusion showed relative fluorescence maxima (transplant vs. surrounding) of 33% or 37%, respectively, whereas these values lay above 64% for all other examinations.

Conclusion

It was possible to prove the feasibility of endoscopic ICG angiographies in patients with free tissue transfer to the upper aerodigestive tract. The method is easy to perform and there were no adverse events. Especially in difficult situations (e.g. questionable Doppler signals, flaps situated far down in the pharynx...) the method seems to be a welcome adjunct to conventional screening.

Author information

Affiliations

  1. Department of Otorhinolaryngology, Head & Neck Surgery, Ludwig Maximilian University Munich, Marchioninistr, Munich, Germany

    Sven Zhorzel, Miriam Havel, Ulrich Harréus & Christian S Betz

  2. Laser-Research Laboratory, LIFE Center, Ludwig Maximilian University, Marchioninistr. 23, 81377, Munich, Germany

    Herbert Stepp

  3. Department of Oral and Maxillofacial Surgery, University College London Hospital, Mortimer Market, London, WC1E 6AU, UK

    Waseem Jerjes, Tahwinder Upile & Colin Hopper

Authors
  1. Sven Zhorzel
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  2. Herbert Stepp
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  3. Miriam Havel
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  4. Waseem Jerjes
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  5. Tahwinder Upile
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  6. Colin Hopper
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  7. Ulrich Harréus
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  8. Christian S Betz
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Corresponding author

Correspondence to Sven Zhorzel.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Cite this article

Zhorzel, S., Stepp, H., Havel, M. et al. Endoscopic examinations of free flap perfusion in the head and neck region using red-excited Indocyanine Green. Head Neck Oncol 1, P29 (2009). https://doi.org/10.1186/1758-3284-1-S1-P29

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Keywords

  • Reconstructive Surgery
  • Neck Surgery
  • Revision Surgery
  • Surrounding Tissue
  • Current Investigation

Head & Neck Oncology

ISSN: 1758-3284