The Role of the Wnt Antagonist Dickkopf-1 Gene in Oral Squamous Cell Carcinoma

Abstract

influenced the side from which a fibular flap can be harvested, or in cases with bilateral abnormalities a different flap all together. These results are comparable to studies done by other authors that showed pre-operative imaging influencing reconstruction in 21-25% of patients. Proponents against routine preoperative imaging have used clinical examination coupled with a history of diagnosis or symptoms of peripheral vascular disease to guide the need for pre-operative studies. Arguments against this are due to the relatively high rate of congenital abnormalities that would be missed with this screening. In this review we find a total of 6 patients (8%) with positive pre-operative studies due to congenital abnormalities versus 10 patients (13%) being due to acquired abnormalities, mainly arthrosclerotic plaques. In a study of 495 lower extremity angiograms there was an overall 5.6% of variant trifurcation of the popliteal artery, leading to 2 and rarely 1 vessel runoff to the foot. The results of this study and others highlight the importance of pre-operative imaging prior to fibular flap transfer to identify both acquired and congenital abnormalities in order to decrease risk of vascular compromise to the lower extremity.