Oral and Pharyngeal Reconstruction Using the Free Forearm Flap

Microsurgical Reconstruction for Caustic Injuries of the Oral Cavity and Esophagus

“…They have been successfully used for reconstruction after resection of oral and oropharyngeal tumors. 2 When release of scar contractures leaves behind long, narrow, winding defects, as in our second patient, it is difficult to cover the defect, even with a forearm flap. In such situations, a jejunal segment in the form of a patch, with its mucous surface outside, has been proposed as a suitable option for reconstruction of oral cavity and pharyngeal defects.…”

Reconstruction of circumferential pharyngolaryngectomy using a ‘horseshoe-shaped’ pectoralis major myocutaneous flap

“…4 -7 Gastric pull-up is an alternative currently used in this indication. In the largest retrospective study, Takato et al 11 reported a 22 per cent fistula rate and a 15 per cent stenosis rate. As in the case of the free jejunum flap, gastric pull-up is a reliable method for hypopharyngeal reconstruction, with success and death rates depending on operator experience.…”

“…However, Nakatsuka et al 10 reported a higher rate of fistulae (15 vs 3) and stenoses (13 vs 6) with this technique than with the free jejunum flap. In the largest retrospective study, Takato et al 11 reported a 22 per cent fistula rate and a 15 per cent stenosis rate.…”

Fasciocutaneous free flap reconstruction for squamous cell carcinoma of the hypopharynx

“…Patients had no stenosis, because stricture formation at the esophageal anastomosis line was prevented by making the suture line wavy and larger in diameter. In another report of 33 radial forearm free flaps for the reconstruction of the hypopharynx, one partial necrosis, two persistent fistulas, four small fistulas, and five stenosis of the esophageal anastomosis were observed [15]. Recently, Genden et al [16] reported that 23 patients with 12 anterolateral thigh flaps and 11 radial forearm flaps were able to tolerate an unrestricted oral diet, but 3 patients that underwent reconstruction with radial forearm flaps experienced cervical esophageal stenosis, whereas only 1 patient with an anterolateral thigh flap developed stenosis.…”