Submental flap for vascularized lymph node transfer; a CTA-based study on lymph node distribution.

Abstract:

BACKGROUND:Amongst various options of vascularized lymph node transfers, the submental flap has the lowest risk for iatrogenic lymphedema. The aim of this study was to gain insight into distribution, number, and size of lymph nodes along the mandible using computed tomography angiography (CTA). METHODS:A total of 52 CTA scans of head/neck region were evaluated retrospectively. Lymph nodes in the submental and submandibular region, related to the origin of the submental artery, were recorded using a three-dimensional coordinate system, and standardized using an iterative closest point algorithm. Results were analyzed for gender, location, size, and number. RESULTS:The mean number and size of lymph nodes were 5.30 ± 2.00 and 5.28 ± 1.29 mm, respectively. The mean distance of the lymph nodes to the origin of the submental artery was 25.53 ± 15.27 mm. There was no significant difference between both sides when comparing size (left: 5.39 ± 1.28; right: 5.17 ± 1.34; P = .19), number (left: 5.46 ± 2.10; right: 5.17 ± 1.96; P = .49), and distance (left: 24.78 ± 12.23; right: 26.32 ± 14.73; P = .19). No significance was found between males and females concerning number (P = .60), size (P = .50), and distance (P = .06). CONCLUSION:The variance of lymph node distribution along the mandible may warrant conducting a CTA scan to maximize the number of transferred lymph nodes and aid in flap design.

journal_name

J Surg Oncol

authors

Paulus VAA,Winters H,Hummelink S,Schulten S,Ulrich DJO,Vasilic D

doi

10.1002/jso.26117

subject

Has Abstract

pub_date

2020-07-15 00:00:00

eissn

0022-4790

issn

1096-9098

pub_type

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