Refinement of the free radial forearm flap reconstructive technique after resection of large oropharyngeal malignancies with excellent functional results

Abstract

Preservation of function is a crucial aspect for the evaluation of therapies applied in the field of head and neck cancer. However, preservation of Uta Tschiesner 1 anatomic structures cannot automatically be equated with preservation 1 Clinic for Otorhinolaryngology, Ludwig Maximilians of function. Functional outcome becomes increasingly important particularly for the evaluation of alternative treatment options with equivalent oncological outcomes.University (LMU) Munich, Munich, GermanyAs a result, present studies take into account three topic areas with varying emphasis: (1) the effects of cancer therapy on essential physiological functions, (2) additional therapy-induced side-effects and complications, and (3) health-related quality of life. The present article summarizes vital aspects of clinical research from recent years. Functional outcomes after surgical and non-surgical treatment approaches are presented according to tumor localization and staging criteria. Additional methodological aspects relating to data gathering and documentation as well as challenges in implementing the results in clinical practice are also discussed.

The folded radial forearm flap in soft-palate and tonsillary fossa reconstruction: technical note

“…Numerous surgical solutions have been proposed, based on the use of pharyngeal flaps alone or combined with free flaps, and the procedures are to some extent reminiscent of velopharyngoplasty to repair cleft-palate sequelae 4,7,8,10,13,14,16,17 . All these methods have improved results, but still do not guarantee against velopharyngeal incompetence, which remains the main problem to solve.…”

Swallowing outcomes following primary surgical resection and primary free flap reconstruction for oral and oropharyngeal squamous cell carcinomas: A systematic review

“…Three of the included studies utilized subjective methods to assess swallowing outcomes . Twelve studies used objective methods of assessment . Subjective evaluation included the self‐administered MDADI and UW‐QOL .…”

“…Subjective evaluation included the self‐administered MDADI and UW‐QOL . Six studies utilized gastrostomy dependency, and seven studies utilized tracheostomy dependency as a measure of swallowing assessment . Five studies employed bolus transit time measured with VFSS in the assessment of swallowing .…”

Funktionserhalt nach der Therapie von Kopf-Hals-Tumoren

“…Die Operation bei Oropharynxkarzinomen beinhaltet die Gefahr einer velopharyngealen Insuffi zienz. Einzelne Untersuchungen nach Rekonstruktion mit Radialislappen zeigen nicht nur eine normale orale Ernährung und verständliche Sprache, sondern auch (videofl uoroskopisch) einen kompletten velopharyngealen Verschluss [ 77 ] . Arbeiten zur Kau-und Schluckfunktion nach freien MandibulaFibula-Lappen zeigen, dass die Kaufunktion nach Rekonstruktion allein noch signifi kant erniedrigt ist.…”