Radial forearm flap is a gold standard for oral soft tissue defect reconstruction after tumour ablative surgery of oral cancer in advanced stages. The main disadvantage of this flap is donor site morbidity. The goal of our study was to show versatility of lateral arm flap in 34 cases with different oral defects that were reconstructed after tumour ablation, and to analyse complications and donor site morbidity. Thirty-four patients with advanced stage oral cancer (T3 and T4) underwent tumour ablation with or without suspicious lymph node removal and with immediate reconstruction of oral defect with lateral arm flap. Analysis of complications and donor sites morbidity was carried out. The Michigan Hand Outcome Questionnaire was used to evaluate functional and esthetical donor site outcome during at least one year follow up. Thirty-one patients had successful free flap surgery with uneventful post-surgery period. Flap loss due to vascularity problems was in one case (2.9%). The flap success rate was 97.1%. The donor site was closed primarily in all cases and healed uneventfully. The Michigan Hand Outcome Score was average 94.30%. The lateral arm is an excellent choice for oral reconstruction after ablative tumour surgery. It is versatile, safe and reliable for oral reconstruction with very good functional and aesthetical donor site outcome.
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Chen, C. M., Lin, G. T., Fu, Y. C., Shieh, T.Y., Huang, I. Y., Shen, Y. S., Chen, C. H. (2005). Complication of free radial forearm flap transfers for head and neck reconstruction. Orla Surg. Orla Med. Pathol. Oral Radiol. Endod., 99, 671–676.
Civantos, F. J., Jr., Burkey, B., Fang-Ling Lu, Armstrong, W. (1997). Lateral arm microvascular flap in head and neck reconstruction. Arch. Otolaryngol. Head Neck Surg., 123 (8), 830–836.
Haas, F., Ensat, F., Windhager, R., Stammberger, H., Koch, H., Scharnagl, E. (2007). Reconstructive potential of the lateral arm flap after tumor resection. Microsurgery, 27, 166–173.
Haas, F., Rappl, T., Koch, H., Pittler, P., Scharnagl, E. (1992). Free osteocutaneous lateral arm flap: Anatomy and clinical applications. Micro-surgery, 23, 87–95.
Hage, J. J., Woerdeman, L. A., Smeulders, M. J. (2005). The truly distal lateral arm flap: Rationale and risk factors of a microsurgical workhorse in 30 patients. Ann. Plastic Surg., 54 (2), 153–159.
Harpf, C., Papp, C., Ninković, M., Anderl, H., Hussl, H. (1998). The lateral arm flap: Review of 72 cases and technical refinements. J. Reconstr Microsurg., 14, 39–48.
Hennerbichler, A., Etzer, C., Gruber, S., Brenner, E., Papp, C., Gaber, O. (2003). Lateral arm flap: Analysis of its anatomy and modification using a vascularized fragment of distal humerus. Clin. Anat., 16, 204–214.
Karamürsel, S., Bağdatlý, D., Markal, N., Demir, Z., Celebioğlu, S. (2005). Versatility of lateral arm free flap in various anatomic defect reconstruction. J. Reconstr. Microsurg., 21, 107–112.
Lutz, B. S., Wei, F. C., Chang, S. C., Yang, K. H., Chen, I. H. (1999). Donor site morbidity after suprafascial elevation of the radial forearm flap: A prospective study in 95 consecutive cases. Plast. Recon. Surg., 103, 132–137.
Nahabedian, M. Y., Deune, E. G., Manson, P. N. (2001). Utility of the lateral arm flap in head and neck reconstruction. Ann. Plastic Surg., 46 (5), 501–505.
Reinert, S. (2000). The free revascularized lateral upper arm flap in maxillofacial reconstruction following ablative tumour surgery. J. Cranio-Maxillofac. Surg., 28 (2), 69–73.
Rohrich, R. J., Hobar, P. C. (1992). The use of free tissue transfer in head neck reconstruction. In: Peterson, L. J. (Ed.). Principles of Oral and Maxillofacial Surgery. J. B. Lippincott, Philadelphia, pp. 1015–1040.
Schipper, J., Ridder, G. J., Boedeker, C. C., Fradis, M., Golz, A., Gellrich, N. C. (2003). Lateral upper arm free flap for primary reconstruction of pharyngeal defects in ablative oncological surgery. Ann. Otol. Rhinol. Laryngol., 112, 611–616.
Song, R., Song, Y, Yu, Y. (2005). The upper arm free flap. Clin. Plast. Surg., 9, 27–35.
Swanson, E., Boyd, J. B., Manktelow, R. T. (1990). The radial forearm flap: Reconstructive applications and donor-site defects in 35 consecutive patients. Plast. Reconstr. Surg., 85, 258–266.
Thankappan, K., Kuriokose, M. A., Chanti, S., Sharan, R., Trivedi, N., Vijayaraghavan, S., Sharma, M., Iyer, S. (2011). Lateral arm free flap of oral tongue reconstruction: An analysis of surgical details, morbidity and functional and aesthetic outcome. Ann. Plastic Surg., 66 (3), 261–266.
Yang, G., Chen, B., Gao, Y. (1981). Forearm free skin flap transplantation. Natl. Med. J. China, 61, 139.