Versatility of Radial Forearm Free Flap for Intraoral Reconstruction

Srp Arh Celok Lek. 2015 May-Jun;143(5-6):256-60. doi: 10.2298/sarh1506256j.

Abstract

Introduction: The radial forearm free flap has an important role in reconstruction of the oncologic defects in the region of head and neck.

Objective: The aim was to present and evaluate clinical experience and results in the radial forearm free transfer for intraoral reconstructions after resections due to malignancies.

Methods: This article illustrates the versatility and reliability of forearm single donor site in 21 patients with a variety of intraoral oncologic defects who underwent immediate (19 patients, 90.5%) or delayed (2 patients, 9.5%) reconstruction using free flaps from the radial forearm. Fascio-cutaneous flaps were used in patients with floor of the mouth (6 cases), buccal mucosa (5 cases), lip (1 case) and a retromolar triangle (2 cases) defects, or after hemiglossectomy (7 cases). In addition, the palmaris longus tendon was included with the flap in 2 patients that required oral sphincter reconstruction.

Results: An overall success rate was 90.5%. Flap failures were detected in two (9.5%) patients, in one patient due to late ischemic necrosis, which appeared one week after the surgery, and in another patient due to venous congestion, which could not be salvaged after immediate re-exploration. Two patients required re-exploration due to vein thrombosis.The donor site healed uneventfully in all patients, except one, who had partial loss of skin graft.

Conclusion: The radial forearm free flap is, due to multiple advantages, an acceptable method for reconstructions after resection of intraoral malignancies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / surgery
  • Female
  • Forearm / surgery*
  • Free Tissue Flaps*
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Male
  • Maxilla / surgery
  • Middle Aged
  • Mouth Mucosa / surgery
  • Mouth Neoplasms / surgery
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications / pathology
  • Skin Neoplasms / surgery
  • Skin Transplantation / methods*
  • Tongue Neoplasms / surgery