Design of Radial Forearm Free Flap for Oropharyngeal Reconstruction

ABSTRACT

The reconstruction of defects after the resection of oropharyngeal tumors must not only cover the defect area but also be able to recover its functional structure enabling speech and mastication. To achieve a functional reconstruction, the volume and the length of the pedicle must be suitably designed and a donor site fit for the location and size of the defect must be chosen. However, in reality, the structures in oropharyngeal tumor patients who underwent resection to classify the different defect shapes according to the resection site. Bases on the classification of oropharyngeal defects, we tried to standardize a flap design method for the different defects. We investigated 44 patients who underwent tumor resection and reconstruction surgery for oropharyngeal tumor during the past 3 years at Severance hospital. The defects were divided into 6 zones and 4 types of design methods of radial forearm free flap were standardized. Surgery was performed on 25 patients during September of 1998 to September of 1999 with modified design methods based on the standardized ones. A faster and more efficient flap design was possible due to the standardized method. It was also possible to enable a functional reconstruction in cases where the soft palate was involved without any nasal escape.