Alternative reconstruction of donor defect of free radial forearm flap in head and neck cancer

Abstract

We report our method of restoration of the radial artery in the use of the anterolateral thigh (ALT) flap to overcome the important drawback of sacrificing the radial artery in cases of free radial forearm flap (FRFF), which is indicated for reconstruction of the tongue and other intraoral defects. There were 12 patients in our series, but only seven completed their postoperative evaluations. We harvested FRFF and ALT flaps simultaneously. The former was used for palatal or lip reconstruction and the latter was anastomosed as a flow-through flap to salvage the radial artery. All major donor site problems of the FRFF were solved by coverage by the ALT flap, except for abnormal sensation on the radial side of the donor hand. The FRFF is a proper choice for small tongue or lip defects. When it is chosen for its unique merits, the ALT flap can also serve as an alternative in reconstructing the donor site with least morbidity, including the restoration of patency to the radial artery.