Article
The microvascular radial forearm flap for head and neck reconstruction
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Published: | September 22, 2005 |
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Introduction: Tumor resections in the head and neck with perforating defects to the perivascular sheath due to simultaneous neck dissection require immediate tissue reconstruction. In small defects or minor functional regions (i.e. floor of mouth, partial base of tongue, lateral pharyngeal wall) a wound closure with a pedicled infrahydal muscle flap is sufficient. Wider resections, defects in major functional areas (i.e. soft palate, tongue, larynx) or corresponding regions, where scares have to be avoided (i.e. floor of mouth/inferior tongue, base of tongue/lateral pharyngeal wall, complete piri-form sinus), should be provided with a fasciocutaneuos flap.
Methods: Typical situations of advanced carcinomas in the oral cavity, oro-pharynx, hypopharynx and larynx, where a fasciocutaneuos flap is indicated, are demonstrated in 10 patients. Due to its versatility a microvascular radial forearm flap was chosen in all cases. The surgical approaches and reconstruc-tion methods are discussed and presented.
Results/Conclusions: Because of its characteristics (low thickness, suffizient size, long vessel pedicle, large vessel calipers, easy and safe dissection) the free radial forearm flap is excellently suitable for an anatomical based tissue reconstruction in the head and neck area. Additional bony or cartilagenous resections require a combination with other transplants (i.e. free fibula flap, rib cartilage).