The Clinical Evaluation of The Reconstruction of Radial Forearm Free Flap in the Head and Neck Cancer Surgery

Korean Journal of Head & Neck Oncology 2003;19(2):164-169.
Published online November 30, 2003.

Hyun Jik Kim;Young Chang Lim;Mee Hyun Song;Won Jae Lee;Eun Chang Choi

두경부 악성 종양 절제술후 요골 전완 유리피판을 이용한 재건술의 평가

김현직;임영창;송미현;이원재;최은창

Abstract

Background and Objectives: The reconstruction is very important in Head and neck cancer surgery to repair the defect created by resection of tumors, to enable successful wound healing, to restore function and to provide acceptable cosmesis. The radial forearm free flap has been the most useful reconstructive flap because it provides a moderate amount of thin, pliable, relatively hairless skin and comparatively simple to do with minimal morbidity. The aims of this study is to estimate the outcome of the reconstruction with radial forearm free flap with the several factors in 140 head and neck cancer cases in our hospital for last 10 years. Materials and Methods: Retrospective review of the records of 140 patients underwent resection of the head and neck tumors and reconstruction with a radial forearm free flap from 1993 to 2003. The age, sex of the patients, Primary site, the complication of donor and recipient site, flap survival rate, median time to start diet, patient subjective symtoms about swallowing and articulating and the fact of revision reconstructive surgery were analyzed.
Results
In primary pathologic site, 56 cases were oral cavity cancers, 44 cases, oropharyngeal cancers and 22 cases, hypopharyngeal cancers. Flap survival rate was 93.6% (13 leases). On donor site, wound dehiscence, hematoma, sensory change and infection were noted and on recipient site, most common complication were fistula and wound dehiscence. The complication rate of recipient's site was 19.1 % and donor site, 3.5%. In 118 cases (84.3%), the patients could take all kinds of food. Swallowing difficulty were noted in 22 cases 05.7%). In 5 cases, there was articulation difficulty but most of patients except patients having total laryngectomy (18 cases) couldn't have any difficulty in articulation and speaking.
Conclusion
We conclude that the radial forearm free flap is the most appropriate reconstructive material for treating the defect in head and neck reconstruction.

Key Words: Head and neck neoplasm, Reconstruction, Flap