Cephalometric analysis for microvascular head and neck reconstruction

Head Neck. 2012 Nov;34(11):1607-14. doi: 10.1002/hed.21967. Epub 2012 Jan 31.

Abstract

Background: While a large body of literature exists involving normative measurements for the craniofacial skeleton, few have analyzed the necessary dimensions that are pertinent in reconstruction using microvascular free flaps.

Methods: Cephalometric analysis was performed using 3-dimensional CT scans from 70 adults. Relevant dimensions of the fibula were obtained from a subset of 20 patients.

Results: Normative cephalometric values, including various distances and angles, for the mandible and maxilla were obtained and compared to the dimensions of the fibula. Comparisons were made between measurements from men and women, and patients with full dentition and edentulous patients. Schematics for designing mandibular and maxillary reconstructions are presented.

Conclusion: When premorbid craniofacial anatomy cannot be discerned in the setting of extensive trauma or tumor involvement, normative dimensions may be a helpful guide for flap design and should be in the armamentarium of surgeons engaged in complex head and heck reconstruction.

MeSH terms

  • Adult
  • Aged
  • Cephalometry / methods*
  • Female
  • Fibula / diagnostic imaging*
  • Free Tissue Flaps
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Male
  • Mandible / blood supply*
  • Mandible / diagnostic imaging
  • Mandible / surgery
  • Maxilla / blood supply*
  • Maxilla / diagnostic imaging
  • Maxilla / surgery
  • Microvessels / surgery
  • Middle Aged
  • Plastic Surgery Procedures / methods*
  • Retrospective Studies
  • Surgical Flaps / blood supply*
  • Tomography, X-Ray Computed