To illustrate the postoperative appearance of flap reconstruction in the head and neck with an emphasis on imaging findings that help in differentiating post-treatment changes from recurrent tumor. To familiarize the radiologist flap types.

Taking into consideration the wide spectrum of reconstructive techniques available in the field of head and neck surgery, distortion of normal anatomy and frequent absence of baseline postoperative comparison studies, the radiologist often faces a difficult task in recognizing “normal” postoperative patterns and not misinterpreting them as disease or vice versa. Additionally, postoperative radiation therapy may further obscure the expected appearance of the reconstructed area. Therefore, the initial step in evaluating image studies in these patients should include an exhaustive review of clinical history and...

Classification: Flaps are classified based on the integrity of their vascular supply into either free or pedicled and are used for closing large surgical defects after resection of advanced malignant tumors It is possible to differentiate both type by recognizing the arteriovenous vessels running along the long axis of the rotated bulk of muscle in pedicled flaps (fig. 3), while free myocutaneous flaps appear as a soft-tissue mass composed mostly by fat that was transferred from one anatomic location to another (fig. 1). Free osteomyocutaneous...

The knowledge of the type of flap utilized in head and neck recontruction and its expected appearance on subsequent CT or MR studies is essential while screening for malignancy recurrence and aids the radiologist to differentiate them from normal post-treatment findings that may mimic desease on CT or MR studies.

1. Chong J,Chan LL,Langstein HN,Ginsberg LE. MR Imaging of the Muscular Component of Myocutaneous Flaps in the Head and Neck. AJNR 22:170–174, January 2001. 2. Lawrence E. Ginsberg. Imaging Pitfalls in the Postoperative Head and Neck. Seminars in Ultrasound, CT, and MRI, Vol 23, No 6 December, 2002: pp 444-459. 3. Kransdorf MJ, Murphey MD. Soft Tissue Tumors: Post-Treatment Imaging. Radiologic Clinics of North America 44 (2006) 463 –472. 4. Wester DJ , Hansman Whiteman ML , Singer S, Bowen BC, Goodwin J. Imaging ofthe...