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Cook Doppler Probe May Decrease Early Postoperative Returns to Surgery: Presented at AAO-HNSF By Kristina Rebelo SAN DIEGO -- October 6, 2009 -- Use of the implantable Cook Doppler probe in head and neck reconstruction surgical procedures is a reliable technique that may decrease early postoperative returns to surgery, according to a study presented here on October 3 at the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting 2009. “If you carefully listen to the Doppler signal intraoperatively, then potential problems can be resolved during the initial procedure,” said lead author and presenter Patrick C. Angelos, MD, Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University (OHSU). In the observational study, researchers collected data from 200 free tissue transfer (FTT) cases collected from 2007 to 2009. Data from the study group’s cases were compared with a historical control (n = 369), also in a tertiary care hospital, that used traditional postoperative monitoring with the same probe. The indication for FTT in both groups was for reconstruction of head and neck oncologic defects; the primary outcome measure was an early return to surgery (<48 hours). They also looked at overall free flap survival. In the OHSU group, 5.5% (11/200) cases had an early return to surgery with an overall flap survival rate of 93.5% and in the control group, 12.5% (46/369) of patients returned to surgery within 48 hours of the initial surgery (P = .0079) with an overall free flap survival rate of 98.1% (P = .0044). Stated limitations of the study were that the data were prospectively collected and that this was an observational study, not a randomised, head-to-head trial. “Therefore, the level of evidence is lower to support the conclusion,” said Dr. Angelos. “The take-home message from our study is that the intraoperative use during the initial procedure may obviate the need for early return to the OR [operating room] for vessel revision,” he said. “I’m looking forward to additional well-designed studies that will evaluate the overall efficacy of the Cook Doppler probe. I think this is becoming a reliable method for intraoperative and postoperative monitoring in microvascular reconstruction.” [Presentation title: Intraoperative Cook Doppler Use in Free Tissue Transfer. Poster SP126.] E-mail this page to a friend or colleague! To print, use this version