radial forearm flap in reconstruction of head and neck cancer defects

ABSTRACT

The radial forearm fasciocutaneous flap possesses several criteria that favours its use in head and neck reconstruction thin pliable skin, large caliber of vascular pedicle with possible inclusion of tendons or bone with flap harvesting. The absence of bulk and sufficient pedicle length are particularly important for intraoral reconstruction. Twenty cases underwent primary reconstruction of their head and neck defects with the radial forearm flap. There were 12 males and 8 females. The tongue was the most common site [12 cases]. Four cases had carcinoma of the lip and the remaining four had their primary in the facial skin. Flap design was modified according to the defect; a bibbed flap was used to reconstruct tongue and floor of mouth defects [12 cases]. Palmaris longus tendon was used to fashion a commissure [two cases]. Three cases had complete loss of their flaps due to venous obstruction. In two cases, partial loss of the flap was evident, they were managed by debridement of the gangrenous area. The overall success rate was 85%. Donor site morbidity consisted of loss of split thickness graft in two cases that required regrafting. Functional and aesthetic results were satisfactory. The radial forearm flap has a established role in the management of head and neck cancer patients; and a success rate of over 85% is expected which should improve with experience in the technique of microvascular anastomosis