Prior to free flap transplantation, we evaluated various blood vessels using Doppler ultrasonography and then decided which of them should be used as recipient vessels for anastomosis. The facial artery and vein, superior thyroid artery and vein, and transverse cervical artery and vein were evaluated as potential recipient vessels. Concerning the items assessed during the vascular waveform analysis, the vascular diameter, F-V, maximum systolic velocity, resistance index, pulsatility index, and acceleration time were measured based on arterial waveforms. The diameters of the target veins were also measured. In all cases, the candidate vessels for anastomosis exhibited normal preoperative waveforms, indicating that there were no problems with their blood flow. During the subsequent surgery, we only had to gain access to the recipient vessel and so were finished within a short period of time. Due to the effects of neck dissection, the planned recipient vessel was not available in one patient, but the anastomosis was performed as planned in all other cases. Doppler ultrasonography can be used to obtain detailed blood flow information, such as about the distribution of the vascular network, vascular diameter, flow velocity, flow volume, and arterial waveform. For this reason, we suggest that it should be performed routinely prior to surgery.
