Color Doppler Ultrasound Assessment of Anterolateral Thigh Flap Perforators in Locally Advanced Head and Neck Cancer

To overcome anatomic variations and make the anterolateral thigh flap (ALT) harvesting simpler and safer, we used color Doppler ultrasound to locate the cutaneous perforators preoperatively and evaluated the reliability for perforator vessels. Twenty-six patients with advanced head and neck cancer who underwent curative surgery between 2012 and 2013 were recorded. The characteristics of cutaneous perforators of the ALT were evaluated preoperatively by color Doppler ultrasound. Fifty-seven perforators detected by preoperative color Doppler ultrasound were found intraoperative. The 4 false-positive perforators were found to be a branch of suprafascial plexus in the subcutaneous fat. The average number of perforators per flap was 2.4 (range, 1–4). The color Doppler ultrasound, therefore, has an 88.3% true-positive rate. The false-positive rate was 6.7%, and the false-negative rate was 5.0%. The diameters detected by preoperative color Doppler ultrasound and by surgeons during the operations were significant ...