Radial forearm flap in head and neck reconstructive surgery. Application experience and selection of the venous system of the tissue flap

Kravets O.V., Cherniienko V.V., Burtyn O.V., Smolanka I.I. (junior)

Summary. Introduction. Methods of removal of the radial forearm flap (RFF) are constantly being developed. These methods are aimed at reducing the frequency of postoperative complications, improving the survival of the tissue flap and the functional outcomes of reconstruction. Aim. To study the functional outcomes of the use of RFF for repairing defects of the tongue and cheeks, as well as compare the effectiveness of the venous systems of the tissue flap. Materials and methods. There was conducted a retrospective study of the outcomes of reconstructive treatment of 75 patients with locally advanced squamous cell carcinoma of the tongue and buccal mucosa who had plastic repair of surgical defects with the use of RFF at the National Cancer Institute over the period 2009–2020. Results. Functional status measures on the Performance Status Scale for Head and Neck Cancer Patients in the repair of half-tongue defects, subtotal tongue defects and cheek defects: normalcy of diet – 83.7±9.3; 61.0±9.4; 85.7±13.4 points, respectively; eating in the presence of other people — 80.8±14.2; 64.5±12.5; 80.6±14.5 points, respectively; speech intelligibility — 87.5±12.7; 66.1±12.2; 92.9±11.6 points, respectively. In the group of patients where one venous anastomosis was imposed with a deep venous system of RFF, thrombosis of the microvascular anastomosis developed in 3 (6.4%) cases, and in the group where a venous anastomosis was imposed with a superficial venous system it occurred in 2 (8.3%) (p>0.05). Conclusions. The use of RFF is an effective method of plastic repair of surgical defects of the tongue and cheeks, which allows achieving high survival rates of the tissue flap and functional rehabilitation of cancer patients. There has not been revealed any differences in the frequency of venous thrombosis when using RFF with superficial and deep venous systems.

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