Free radial artery forearm flap reconstruction in various intraoral defects after tumour resection – Our experience

Abstract

Background: A free radial forearm flap popularly known as “The Chinese flap” is the workhorse flap for oral cavity reconstruction after intraoral tumour resection. The aim was to highlight the versatility of the free radial artery forearm flap in various intraoral defects. Method: From 2017 to 2019, a total of 24 cases were operated for intraoral defect reconstruction after tumour resection by free radial artery forearm free flap. The patients had a mean age of 48 years (range 32-70). The most common histopathological diagnosis was squamous cell carcinoma in 22 cases. The free radial artery flap was used to reconstruct defects of tongue(8 cases), buccal mucosa(8 cases), lip(3 cases), retromolar trigone(3 cases) and the floor of mouth(2 cases).  The mean flap size was 33cm² and mean pedicle size was 8.7 cm. Results: Twenty four patients underwent intraoral reconstruction after tumor ablation with a free radial artery forearm fasciocutaneous flap. Two of the cases required immediate  rexploration of which one could not be salvaged and was reconstructed with pectoralis major myocutneous flap. The success rate of the flap survival was 95.8% with satisfactory post operative outcome. Conclusion: The free radial artery forearm flap is a versatile, thin, pliable and reliable option for intraoral defect reconstruction after tumour ablation. The flap is easy to harvest with predictable vascular anatomy and a reasonable size of paddle for reconstructing various oral oncologic defect.

Keywords: Free radial artery forearm flap, versatile, intraoral defect.