Versatility and Donor Site Morbidity of the Lateral Upper Arm Flap in Intraoral Reconstruction

Abstract

OBJECTIVE: The lateral upper arm flap is not widely used yet for intraoral defect reconstruction. Investigation of its morphologic and functional outcome was the objective of this study.

STUDY DESIGN: The morphologic and functional results of recipient (swallowing, flap survival, dehiscence of margins, cutaneous fistulas, intraoral hairs) and donor sites (wound healing, scar width and length, sensory and motor disturbance) (n = 44) were checked clinically. Postoperative swallowing was investigated via videofluorography (n = 11).

RESULTS: The lateral upper arm flap showed low donor site morbidity, primary closure was achieved in all but one case. Sensory deficit at the proximal forearm (n = 27) occurred without any case of compromise of radial nerve function. Videofluorography allows for objective evaluation of swallowing function.

CONCLUSIONS: The lateral upper arm flap is the reconstruction of first choice for intraoral defects due to its low donor site morbidity.

Get full access to this article

View all access options for this article.

References

1. Gellich

N-C

Bremerich

Kugler

, Rehabilitation in der Mund-, Kiefer- und Gesichtschirurgie — eine patientengestützte Studie beim Mundhöhlenkarzinom. Dtsch Z Mund Kiefer Gesichts Chir 1993;17:215–7.

Schmelzeisen

Neukam

Hausamen

J-E.

Atlas der Mikrochirurgie im Kopf-Halbereich. Muenchen: Carl Hanser Verlag; 1996.

3. Millesi

Rath

Millesi-Schobel

, Reconstruction of the floor of the mouth with a fascial radial forearm flap, prelaminated with autologous mucosa. Int J Oral Maxillofac Surg 1998;27:106–10.

4. Richardson

Fisher

Vaughan

, Radial forearm flap donor-site complications and morbidity: A prospective study. Plast Reconstr Surg 1997;99:109–15.

Gellich

N-C

Kwon

Lauer

Fakler

Otten

J-E

Schmelzeisen

The value of lateral upper arm free flap for intraoral reconstruction. Int J Oral Maxillofac Surg 2000; 29: 104–11.

Reinert

Gellrich

N-C

Eufinger

The free revascularized lateral upper arm flap in intraoral reconstruction following ablative tumor surgery. J Craniomaxillofac Surg 1990;24:93.

7. Civantos

Jr Burkey

, Lateral arm microvascular flap in head and neck reconstruction. Arch Otolaryngol Head Neck Surg 1997;123:830–6.

Sullivan

Carrol

Kuriloff

DB.

Lateral arm free flap in head and neck reconstruction. Arch Otolaryngol Head Neck Surg 1992;118:1095–101.

Graham

Adinks

Schenker

LR.

Complications and morbidity of the donor and recipient sites in 123 lateral arm flaps. J Hand Surg 1992;17:189–92.

10.

Dodds

Logemann

Stewart

ET.

Radiologic assessment of abnormal oral and pharyngeal phases of swallowing. AJR 1990;154:965–74.

11.

11. Matloub

Larson

Kuhn

, Lateral arm free flap in oral cavity reconstruction: A functional evaluation. Head Neck 1989;11:205–11.

12.

12. Harpf

Papp

Ninkovic

, The lateral arm flap: Review of 72 cases and technical refinements. J Reconstr Microsurg 1998;14:39–48.

13.

13. Jacobson

Franssen

Fliss

, Free forearm flap in oral reconstruction: Functional outcome. Arch Otolaryngol Head Neck Surg 1995;121:959–64.

14.

Fogdestam

Tarnow

Kalaaji

Extended free lateral arm flap with preservation of the posterior cutaneous nerve of the forearm. Scand J Plast Reconstr Surg Hand Surg 1996;30:49–55.

15.

15. Lanzetta

Bernier

Chollet

, The lateral forearm flap: An anatomic study. Plast Reconstr Surg 1997;99:460–4.

16.

16. Katsaros

Tan

Zoltie

, Further experience with the lateral arm free flap. Plast Reconstr Surg 1991;87:902–10.

17.

17. Rivet

Buffet

Martin

, The lateral arm flap: An anatomical study. J Reconstr Microsurg 1987;3:121–32.

18.

Wenig

BL.

The lateral arm free flap for head and neck reconstruction. Otolaryngol Head Neck Surg 1993;109:116–9.