title: Retromolar trigone reconstructive surgery: prospective comparative analysis between free flaps.
abstract: OBJECTIVE
  Retromolar trigone (RMT) tumours are rare and aggressive malignancies, which require an aggressive surgical approach. The reconstruction oral cavity defects represent a challenge because of the critical role of this area both aesthetically and functionally. Free radial forearm (RF) or anterolateral thigh (ALT) flap are the first choice for the repair of intraoral defects. In reviewing the literature, there is lack of evidence pertaining to the differences between RF and ALT flaps in the reconstruction of patients with RMT tumours. This study evaluates the better microvascular reconstruction after RMT cancer resection.
  
  
  METHODS
  Thirty patients with RMT cancer underwent oropharingectomy and microvascular reconstruction using the free RF flap (RF group) and the ALT perforator flap (ALT group). The two groups were homogeneous for sex, age, anatomic area, body mass index, and clinicopathologic profile. Viability, complications, scarring, cosmetic appearance, disorder of sensations, ROM, disease-specific items and satisfaction rate were analyzed, and statistical analysis was performed.
  
  
  METHODS
  Prospective study.
  
  
  RESULTS
  There were differences between the RF and ALT groups in the morphofunctional outcomes, both short-term and long-term follow-up. These differences were statistically significant (p < 0.05) for donor site complications, cosmetic appearance, and scar evaluations. Manual dexterity was slower on the operated donor side than on the nonoperated side in the 33.3 % in the RF group.
  
  
  CONCLUSIONS
  The study showed that the free ALT perforator flap provides better results in appearance and scarring than the RF flap for intraoral reconstruction after RMT cancer resection.
authors.affiliation: Plastic Reconstructive Surgery Unit, La Sapienza University of Rome, Rome, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cigna
authors.forename: Maria Ida
authors.initials: MI
authors.lastname: Rizzo
authors.forename: Antonio
authors.initials: A
authors.lastname: Greco
authors.forename: Armando
authors.initials: A
authors.lastname: De Virgilio
authors.forename: Annapina
authors.initials: A
authors.lastname: Palmieri
authors.forename: Michele
authors.initials: M
authors.lastname: Maruccia
authors.forename: Diego
authors.initials: D
authors.lastname: Ribuffo
authors.forename: Nicolò
authors.initials: N
authors.lastname: Scuderi
authors.forename: Marco
authors.initials: M
authors.lastname: De Vincentiis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D019647:Oral Surgical Procedures / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps