Long-term functional outcome and satisfaction after radial forearm free flap reconstructions of intraoral malignancy resections.
OBJECTIVE
Evaluation of objective and subjective functional follow-up results of intraoral radial forearm free flap reconstructions.


METHODS
A total of 149 patients had received radial forearm free flaps between January 1996 and December 2005. Seventy-two patients completed a European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35 (EORTC H&N35) in the follow-up study. Patients were divided according to location of defect (anterior or posterior) or irradiation. Thirty-nine patients with anterior positioned flaps received standardised physical examinations.


RESULTS
Flap survival was 99.3%. Complications were divided in early (<2 weeks; 23%) and late complications (20%). Most common complications were dehiscence or fistula, responding well to conservative treatment. Analysis of questionnaire subscales showed no statistically significant differences between anterior and posterior defects. Irradiation showed significant impairment for the ability to smell and taste. No important donor site impairment was found.


CONCLUSIONS
The radial forearm free flap is an adequate method for reconstructions after resection of intraoral malignancies. Subjective functional outcome seemed to be defined by adjuvant radiotherapy, patient coping and, to a lesser extent, flap bulk for anterior defects.
Rhemrev
R
R
Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
Rakhorst
H A
HA
Zuidam
J M
JM
Mureau
M A M
MA
Hovius
S E R
SE
Hofer
S O P
SO
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy / Q000379:methods; D003679:Deglutition / Q000502:physiology; D005260:Female; D005542:Forearm; D006801:Humans; D008297:Male; D008409:Mastication / Q000502:physiology; D008875:Middle Aged; D009055:Mouth / Q000601:surgery; D009062:Mouth Neoplasms / Q000503:physiopathology / Q000532:radiotherapy / Q000601:surgery*; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications; D011788:Quality of Life; D012189:Retrospective Studies; D013064:Speech Disorders / Q000503:physiopathology; D013524:Surgical Flaps; D016896:Treatment Outcome