-To perform an iconographic essayof computed tomography (CT) pre and postoperative images of patients who had undergone microsurgical reconstruction with free flaps (FFs) and followed up in a head and neck (H&N)cancer referral service. In some cases, magnetic resonance imaging (MRI) was also performed. - To demonstrate surgical FFs options, expected postoperative appearance and common complications. - To facilitate postoperative interpretation of images in the set of such microsurgical reconstructions.

H&N reconstructive procedures are considered a surgical challenge due to the complex anatomy and difficulty in achieving functional and aesthetic outcomes. Along with the traditional local and regional flaps, FFs have recently become an accepted method of reconstruction owing to increased success rates (Fig. 2). The main indication for H&N microsurgical reconstruction (FFs) is malingnant tumor resection.The postoperative imaging interpretation in this contextrequires the radiologist to be aware of the patient's clinical summary and surgical choice, as well as the expected postoperative appearance and common...

Grafts x Flaps: in H&N surgical reconstruction, flaps or grafts may be used (Fig. 4). These methods have the following features: Grafts: - Vasculature is transected at the donor site, being the graft inserted without a vessel-to-vessel anastomosis. A new supply is provided by further angiogenesis. Flaps: - Vascular supply is intact. Therefore, a larger volume of surgery is possible and different types of tissue constituents can be used. Also, a more predictable and faster healing is expected,with less contracture than H&N grafts. Flaps classification:...

For best postoperative imaging evaluation of FF, the radiologist should be also aware of the clinical and surgical data, in order to look for complications such as necrosis, infection and local disease recurrence. This perception is fundamental for improving the interdisciplinary approach.

J. Albuquerque; Rio de Janeiro/BR - Radiology resident. No conflict of interest.E-mail:[email protected] V. R. F. Simonini; Rio de Janeiro/BR -Radiology resident. No conflict of interest. E-mail:[email protected] R. Costa; Rio de Janeiro, TO/BR - Radiology resident. No conflict of interest.E-mail:[email protected] M. F. Uberti; Rio De Janeiro/BR - Radiology resident.E-mail:[email protected] H. Santos de Souza; Rio de Janeiro/BR - Radiology resident. No conflict of interest.E-mail:[email protected] B. Albuquerque Sousa; Rio de Janeiro/BR - Head and neck surgeon. No conflict of interest. E-mail: [email protected] F. Miraldi; Rio de Janeiro/BR -...

1) Dassonville O, et al. Head and Neck Reconstruction with Free Flaps: A Report On 213 Cases. Eur Arch Otorhinolaryngol. 2008; 265: 85-95. 2) Podrecca S, et al. Review Of 346 Patients with Free-Flap Reconstruction Following Head and Neck Surgery for Neoplasm. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2006; 59, 122–129. 3) Dassonville O, et al. Head and Neck Reconstruction with Free Flaps: A ReportOn 213 Cases. Eur Arch Otorhinolaryngol. 2008; 265:85–95. 4) Chim H, et al. Principles of Head and Neck Reconstruction: An...