Effect of computed tomographic venography on donor selection in submandibular gland transplantation in patients with severe dry eye

Publication date: Available online 29 July 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Jia-Zeng Su, Hong-Kui Yu, Zhi-Peng Sun, Xiao-Jing Liu, Zhi-Gang Cai, Lan Lv, Guang-Yan Yu
BackgroundA reliable anterior facial vein (AFV, donor vein) is cardinal for the success of submandibular gland (SMG) transplantation. This study determined the impact of computed tomographic (CT) venography in identifying AFV variations for SMG transplantation.MethodsCT venography was performed in consecutive patients with severe dry eye prior to SMG transplantation in order to identify disadvantageous AFV variations for vascular anastomosis, namely, AFVs that did not drain the SMG and those that did not match the superficial temporal vein (STV, recipient vein; AFV:STV caliber ratio, ≥3). The CT results were compared with the intraoperative findings for the diagnostic accuracy.ResultsForty-two donors were included. Compared with the intraoperative findings, the CT results accurately identified AFV–STV caliber mismatches (P = 1.00; sensitivity and specificity, 100%). In the identification of AFVs not draining the SMG, CT showed 94.7% sensitivity and 100% specificity (P = 0.25). According to the CT findings, 10 contralateral SMGs with AFVs (23.8%), instead of ipsilateral donors, were selected for transplantations (conventionally ipsilateral donor was the first choice). The surgical success rate was 95.2% (40/42).ConclusionCT venography is valuable in determining disadvantageous AFV variations for anastomosis and choosing a reliable donor for SMG transplantation.



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