Abstract
Free radial forearm flaps were employed in 16 cases for the reconstruction of orofacial defects. The patients, 12 males and four females, ranged in age from 43 years to 78 years. The primary sites were as follows: four cases in the tongue, four cases in the buccal mucosa, four cases in the oral floor, three cases in the pharyx, and one case in the lower gum. Histologically, 14 cases featured squamous cell carcinoma, one involved mucoepidermal carcinoma, and one adenoidocystic carcinoma. The post-operative course was uneventful in 14 cases and total necrosis of the flap was seen in two cases. These failures were due to venous thrombosis and arterial thrombosis. Thrombosis of the artery was thought to be caused by an inappropriate recipient artery used for arterial injection of 5-FU during induction chemotherapy, re-clamping of a vein immediately following anastomosis, and compression to an artery. Venous thrombosis was caused by arterial occlusion resulting from kinking or torsion of anastomosed vessels following closure of an incision.
As it is thin and supple and has few limitations in terms of its size and shape, the radial forearm flap is suitable for repairing wide, though not bulky, defects. It also has a great advantage in its ability to treat defects that require mobility, such as the tongue and oral floor, as well as defects that have unique anatomical features, such as the buccal mucosa, retromolar region, and pharynx.
