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Asymptomatic lower extremity deep venous thrombosis resulting in fibula free flap failure

Authors

  • Adam S. Jacobson MD,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, Institute for Head, Neck, and Thyroid Cancer, Beth Israel Medical Center, New York, New York, U.S.A.
    • Department of Otolaryngology–Head and Neck Surgery, Institute for Head, Neck, and Thyroid Cancer, Beth Israel Medical Center, 10 Union Square East, Suite 5b, New York, NY 10003

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  • Azita S. Khorsandi MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Institute for Head, Neck, and Thyroid Cancer, Beth Israel Medical Center, New York, New York, U.S.A.
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  • Daniel Buchbinder DMD, MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Institute for Head, Neck, and Thyroid Cancer, Beth Israel Medical Center, New York, New York, U.S.A.
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  • Mark L. Urken MD

    1. Department of Otolaryngology–Head and Neck Surgery, Institute for Head, Neck, and Thyroid Cancer, Beth Israel Medical Center, New York, New York, U.S.A.
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  • Presented at the Eastern Section of the Triological Society, Boston, Massachusetts, U.S.A., January 23–25, 2009.

Abstract

Objectives/Hypothesis:

The successful harvest and transplant of a fibular flap depends on many factors, including healthy inflow and outflow systems. A contraindication to harvesting a fibular flap is disease of the lower extremity arterial system; therefore, preoperative evaluation of the arterial system is routine. Preoperative evaluation of the venous system is not routine, unless there is clinical suspicion of venous disease.

Methods:

Retrospective chart review.

Results:

Two cases of occult deep venous thrombosis (DVT) were encountered intraoperatively resulting in nontransplantable flaps.

Conclusions:

This finding represents a serious concern, and we believe that venous imaging should be considered in patients with significant risk factors for harboring an occult DVT. Laryngoscope, 2009

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