Reliability of Free Radial Forearm Flap for Tongue Reconstruction Following Oncosurgical Resection
Introduction Primary closure following oncosurgical resection of carcinoma tongue has been found to compromise tongue function in regards to speech and swallowing very badly. In contrast, reconstruction of tongue with free radial forearm flap following oncosurgical resection has shown promising fun...
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doaj-1a11981e8ed6413387017908a524124a2020-11-24T23:50:53ZengThe Association of Otolaryngologists of India, West BengalBengal Journal of Otolaryngology and Head Neck Surgery2395-23932395-24072015-08-01232576252Reliability of Free Radial Forearm Flap for Tongue Reconstruction Following Oncosurgical ResectionGaurab Ranjan Chaudhuri0R G Kar Medical College, KolkataIntroduction Primary closure following oncosurgical resection of carcinoma tongue has been found to compromise tongue function in regards to speech and swallowing very badly. In contrast, reconstruction of tongue with free radial forearm flap following oncosurgical resection has shown promising functional outcome. Materials and Methods Thirteen patients (ten male and three female) with squamous cell carcinoma involving anterior 2/3rd of tongue had undergone either hemiglossectomy or subtotal glossectomy. Reconstruction was done with free radial forearm flap following oncosurgical resection and neck dissection. All of them received postoperative radiotherapy. Follow-up ranged from 2 months to 2 years. The age of the patients ranged between 32 and 65 years. Flap dimension ranged from 7x6 cm to 10x8 cm. Vascular anastomosis performed in an end-to-end manner with 8-0 Ethilon® under loupe magnifiacation. Results Venous congestion occurred in one patient after 48 hours postoperatively and the flap underwent complete necrosis on postoperative day 5. Postoperative hematoma was found in one patient within first 24 hours of reconstruction. Re-exploration was done immediately, blood clots were removed. No fresh bleeding point was seen and the flap survived. In this series, 12 out of 13 flaps survived completely (92%). Conclusion The free radial forearm flap has become a workhorse flap in head and reconstruction due to its lack of extra bulk, relative ease of dissection, long vascular pedicle, good calibre vessels, malleability and minimal donor site morbidity. Furthermore its low flap loss and complication rate offer the best choice for tongue reconstruction.http://bjohns.in/journal/index.php/bjohns/article/view/55Carcinoma, Squamous CellTongueGlossectomyReconstructive Surgical ProceduresFree Tissue FlapsForearmRadial ArteryUlnar Artery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Gaurab Ranjan Chaudhuri |
spellingShingle |
Gaurab Ranjan Chaudhuri Reliability of Free Radial Forearm Flap for Tongue Reconstruction Following Oncosurgical Resection Bengal Journal of Otolaryngology and Head Neck Surgery Carcinoma, Squamous Cell Tongue Glossectomy Reconstructive Surgical Procedures Free Tissue Flaps Forearm Radial Artery Ulnar Artery |
author_facet |
Gaurab Ranjan Chaudhuri |
author_sort |
Gaurab Ranjan Chaudhuri |
title |
Reliability of Free Radial Forearm Flap for Tongue Reconstruction Following Oncosurgical Resection |
title_short |
Reliability of Free Radial Forearm Flap for Tongue Reconstruction Following Oncosurgical Resection |
title_full |
Reliability of Free Radial Forearm Flap for Tongue Reconstruction Following Oncosurgical Resection |
title_fullStr |
Reliability of Free Radial Forearm Flap for Tongue Reconstruction Following Oncosurgical Resection |
title_full_unstemmed |
Reliability of Free Radial Forearm Flap for Tongue Reconstruction Following Oncosurgical Resection |
title_sort |
reliability of free radial forearm flap for tongue reconstruction following oncosurgical resection |
publisher |
The Association of Otolaryngologists of India, West Bengal |
series |
Bengal Journal of Otolaryngology and Head Neck Surgery |
issn |
2395-2393 2395-2407 |
publishDate |
2015-08-01 |
description |
Introduction
Primary closure following oncosurgical resection of carcinoma tongue has been found to compromise tongue function in regards to speech and swallowing very badly. In contrast, reconstruction of tongue with free radial forearm flap following oncosurgical resection has shown promising functional outcome.
Materials and Methods
Thirteen patients (ten male and three female) with squamous cell carcinoma involving anterior 2/3rd of tongue had undergone either hemiglossectomy or subtotal glossectomy. Reconstruction was done with free radial forearm flap following oncosurgical resection and neck dissection. All of them received postoperative radiotherapy. Follow-up ranged from 2 months to 2 years. The age of the patients ranged between 32 and 65 years. Flap dimension ranged from 7x6 cm to 10x8 cm. Vascular anastomosis performed in an end-to-end manner with 8-0 Ethilon® under loupe magnifiacation.
Results
Venous congestion occurred in one patient after 48 hours postoperatively and the flap underwent complete necrosis on postoperative day 5. Postoperative hematoma was found in one patient within first 24 hours of reconstruction. Re-exploration was done immediately, blood clots were removed. No fresh bleeding point was seen and the flap survived. In this series, 12 out of 13 flaps survived completely (92%).
Conclusion
The free radial forearm flap has become a workhorse flap in head and reconstruction due to its lack of extra bulk, relative ease of dissection, long vascular pedicle, good calibre vessels, malleability and minimal donor site morbidity. Furthermore its low flap loss and complication rate offer the best choice for tongue reconstruction. |
topic |
Carcinoma, Squamous Cell Tongue Glossectomy Reconstructive Surgical Procedures Free Tissue Flaps Forearm Radial Artery Ulnar Artery |
url |
http://bjohns.in/journal/index.php/bjohns/article/view/55 |
work_keys_str_mv |
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