title: The extended lateral arm flap in head and neck reconstruction.
abstract: BACKGROUND
  The lateral arm flap has been proven to be a reliable and versatile flap for the coverage of small to moderated-sized defects, especially in the head and neck and in the extremities. This flap has been modified by either extending the vascular pedicle or the flap territory.
  
  
  METHODS
  From September 1997 to October 2000, we performed 17 free lateral arm flaps with extension of the flap size, including 1 osteofasciocutaneous flap for the coverage of head and neck defects. The reconstructions included a partial circumference defect of the esophagus, extensive intraoral defects, through-and-through bucco-cheek defect, etc. Follow-up was from three months to 12 months, with an average of 8 months.
  
  
  RESULTS
  All but one flaps survived completely. Necrosis of the distal part occurred in one flap. Follow-up of donor sites revealed minimal morbidity when the flaps were extended to the below-elbow level.
  
  
  CONCLUSIONS
  The cutaneous territory of the lateral arm flap, based on the posterior radial collateral artery, can be extended distally onto the forearm up to 10 cm. The center point of the flap design could be located more distally toward the lateral epicondyle in order to increase the size of the flap and the length of the vascular pedicle. The lateral arm flap provides a considerable amount of thin, pliable fasciocutaneous tissue. The advantages of the flap are constant anatomy, very easy and fast dissection, and the donor site being easier to camouflage than that of the radial forearm flap. The lateral arm flap is an excellent choice of fasciocutaneous flap for the reconstruction of head and neck defects.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
authors.forename: I-Chen
authors.initials: IC
authors.lastname: Chen
authors.forename: Chuan-Yuan
authors.initials: CY
authors.lastname: Lin
authors.forename: Rong-Shinn
authors.initials: RS
authors.lastname: Yen
authors.forename: Ling-Fen
authors.initials: LF
authors.lastname: Ou
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Tan
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm; D044964:Cervicoplasty / Q000379:methods; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps