CT AND MRI OF JEJUNAL PATCHES AFTER OROPH ARYNGEAL TUMOR RESECTIONS

Freely transplanted, microvascularly anastomosed jejunal patches can b e used to cover soft tissue defects in the oral cavity or oropharynx a fter the resection of malignant tumors. Even a patch without complicat ions or alteration from tumor recurrence is morphologically diverse. T herefore it is difficult to distinguish between malignant and benign a lterations, and knowledge of the possible morphological spectrum and t he significance of an alteration is of practical interest. Computed to mography (CT; n = 30) and magnetic resonance imaging (MRI; n = 13) wer e used for follow-up examinations in patients who had an operative rec onstruction with a jejunal patch. Three parts of a patch were differen tiated with both imaging modalities: the region of the anastomosis, th e mesenterial fatty tissue and the intestinal wall. The morphology of the patches correlated with clinical findings in the following cases. The patches were identified satisfactorily by CT and MRI. The appearan ce of patches without complications was influenced by a variable degre e of fibrosis and by persistent intestinal folds. Recurrent tumors onl y infiltrated the margins of the patches; Destructive alterations in t he patches were always less severe than those in the original orofacia l soft tissue. Postoperative follow-up examinations with CT and MRI ar e particularly important when tumor recurrences spread under a patch, since these tumors are invisible in the clinical examinations. CT was advantageous in demonstrating osseous alterations and showed less loss of image quality in patients for whom the implantation of multiple me tallic hardware during the operation had been necessary.