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. 2016:28:270-273.
doi: 10.1016/j.ijscr.2016.10.019. Epub 2016 Oct 12.

Osseocutaneous radial forearm flap with beavertail modification; a case report of a novel, single, reconstructive free flap for the tongue, floor of mouth and mandible

Alastair Henry  1 , James A McCaul  2
Affiliations

Osseocutaneous radial forearm flap with beavertail modification; a case report of a novel, single, reconstructive free flap for the tongue, floor of mouth and mandible

Alastair Henry et al. Int J Surg Case Rep. 2016.

Abstract

Introduction: Complex hard and soft tissue defects produced as a result of ablative resection of head and neck malignancy can represent a reconstructive challenge, especially when patients are medically compromised.

Presentation of case: We present the case of 72-year-old women presenting with an oral squamous cell carcinoma of the right floor of mouth invading the right mandible. Surgical management of the disease required ablative surgery with complex free tissue transfer reconstruction to provide restoration of form and function. Potential reconstructive options were limited by her medical comorbidities and poor vessel patency in the lower limbs, requiring novel thinking and adaptation of established techniques.

Discussion: We describe the first reported use of an osseofasciocutaneous radial forearm flap with a 'beavertail modification' to provide a single and combined reconstructive option to reconstruct a complex hard and soft tissue defect.

Conclusion: This novel free-flap technique adds to the reconstructive armamentarium of the head and neck surgeon.

Keywords: Case report; Novel technique; Osseocutaneous; Radial forearm flap.

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Figures

Fig. 1
Fig. 1
Elevation of the radial forearm fasciocutaneous element with proximal subcutaneous fat and fascia (the beavertail).
Fig. 2
Fig. 2
The beavertail is rolled under the skin paddle demonstrating increased flap volume achieved.
Fig. 3
Fig. 3
Resulting complex defect anterior floor of mouth, ventral tongue and mandible.
Fig. 4
Fig. 4
Osteotomised radial bone forming the neomandible, held by titanium reconstruction plate.
See this image and copyright information in PMC

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