Ultrasound in Head and Neck Oncologic Perforator Flap Reconstruction: Recent Advancements in Preoperative Planning, Intraoperative Assessment, and Postoperative Monitoring

Abstract

Head and neck (H&N) oncologic reconstruction heavily relies on perforator flaps. Meticulous flap planning and early identification of vascular compromises are key to ensuring a high flap survival rate. Recent advancements in perioperative use of ultrasound have made it a versatile adjunct to traditional assessment methods to address their limitations. This comprehensive review aims to provide an updated narrative review of the evidence behind the current uses and frontier ultrasound modalities in the perioperative H&N oncologic flap reconstruction. The factors affecting the application of each ultrasound modality were analyzed. A comprehensive understanding of current and cutting-edge ultrasound techniques can aid in the development of institutional microsurgical assessment protocols and improve flap survival rates.

Keywords: doppler; duplex; flap monitoring; free flap reconstruction; head and neck neoplasms; microsurgery; oral cavity cancer; perforator flaps; ultrasound.