Top

Head & Face Medicine

Published in:

Open Access 01-12-2016 | Research

Use of modified lateral upper arm free flap for reconstruction of soft tissue defect after resection of oral cancer

Authors: Xu-Dong Yang, Su-Feng Zhao, Qian Zhang, Yu-Xin Wang, Wei Li, Xiao-Wei Hong, Qin-Gang Hu

Published in: Head & Face Medicine | Issue 1/2016

Abstract

Background

To evaluate the suitability of a modified lateral upper arm free flap (LAFF) for reconstruction of soft tissue defects after resection of oral cancer.

Methods

Eighteen cases of soft tissue defect repair performed between January 2011 and December 2013 using a modified LAFF after resection of oral cancer were reviewed. The design and harvest of the LAFF, the reconstruction procedure, and postoperative morbidity were reviewed and evaluated over a follow-up period of at least 12 months.

Results

The overall flap survival was 94.4 % (17/18 patients). A broad scar at the donor site was the most common morbidity, but patients did not report dissatisfaction with the scar because they could easily cover it. All wounds at the donor site achieved primary recovery. One case of flap loss was repaired with a radial forearm free flap. One case complicated by diabetes mellitus involved infection of the flap with one-third of the flap becoming necrotic. This flap survived after removal of the necrotic tissue. In one other case, fat liquefactive necrosis (1.5 × 1.0 cm) occurred in the flap on the tip of the tongue, and this flap survived after debridement. Overall, the shape and function of the reconstructed tissues were well restored, and there was no severe morbidity at the donor site in any case.

Conclusion

The modified LAFF was safe and reliable for the reconstruction of soft tissue defects after resection of oral cancer.

Kelner N, Vartanian JG, Pinto CAL, Coutinho-Camillo CM, Kowalski LP. Does elective neck dissection in T1/T2 carcinoma of the oral tongue and floor of the mouth influence recurrence and survival rates? Brit J Oral Maxillofac Surg. 2014;52(7):590–7. doi:10.1016/j.bjoms.2014.03.020.CrossRef

Wang YY, Tail YH, Wang WC, Chen CY, Kao YH, Chen YK, et al. Malignant transformation in 5071 southern Taiwanese patients with potentially malignant oral mucosal disorders. BMC Oral Health. 2014;14:99. doi:10.1186/1472-6831-14-99.CrossRefPubMedPubMedCentral

Tesseroli MA, Calabrese L, Carvalho AL, Kowalski LP, Chiesa F. Discontinuous vs. in-continuity neck dissection in carcinoma of the oral cavity. Experience of two oncologic hospitals. Acta Otorhinolaryngol Ital. 2006;26(6):350–5.PubMedPubMedCentral

Liu J, Wu H, Zhu Z, Wu X, Tan H, Wang K. Free anterolateral thigh myocutaneous flap for reconstruction of soft tissue defects following en block resection of tongue cancer. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2010;24(1):82–6.PubMed

Song XM, Yuan Y, Tao ZJ, Wu HM, Yuan H, Wu YN. Application of lateral arm free flap in oral and maxillofacial reconstruction following tumor surgery. Med Princ Pract. 2007;16(5):394–8. doi:10.1159/000104815.CrossRefPubMed

Song R, Song Y, Yu Y, Song Y. The upper arm free flap. Clin Plast Surg. 1982;9(1):27–35.PubMed

Thankappan K, Kuriakose MA, Chatni SS, Sharan R, Trivedi NP, Vijayaraghavan S, et al. Lateral arm free flap for oral tongue reconstruction: an analysis of surgical details, morbidity, and functional and aesthetic outcome. Ann Plast Surg. 2011;66(3):261–6. doi:10.1097/SAP.0b013e3181d50e9e.CrossRefPubMed

Agostini T, Lazzeri D, Spinelli G. Anterolateral thigh flap: systematic literature review of specific donor-site complications and their management. J Craniomaxillofac Surg. 2013;41(1):15–21. doi:10.1016/j.jcms.2012.05.003.CrossRefPubMed

Ross DA, Thomson JG, Restifo R, Tarro JM, Sasaki CT. The extended lateral arm free flap for head and neck reconstruction: the Yale experience. Laryngoscope. 1996;106(1 Pt 1):14–8.CrossRefPubMed

10.

Schusterman MA, Miller MJ, Reece GP, Kroll SS, Marchi M, Goepfert H. A single center’s experience with 308 free flaps for repair of head and neck cancer defects. Plast Reconstr Surg. 1994;93(3):472–8. discussion 9–80.CrossRefPubMed

11.

Katsaros J, Schusterman M, Beppu M, Banis Jr JC, Acland RD. The lateral upper arm flap: anatomy and clinical applications. Ann Plast Surg. 1984;12(6):489–500.CrossRefPubMed

12.

Haas F, Seibert FJ, Koch H, Hubmer M, Moshammer HE, Pierer G, et al. Reconstruction of combined defects of the Achilles tendon and the overlying soft tissue with a fascia lata graft and a free fasciocutaneous lateral arm flap. Ann Plast Surg. 2003;51(4):376–82. doi:10.1097/01.sap.0000068080.76814.D7.CrossRefPubMed

13.

Gellrich NC, Kwon TG, Lauer G, Fakler O, Gutwald R, Otten JE, et al. The lateral upper arm free flap for intraoral reconstruction. Int J Oral Maxillofac Surg. 2000;29(2):104–11.CrossRefPubMed

14.

Vico PG, Coessens BC. The distally based lateral arm flap for intraoral soft tissue reconstruction. Head Neck. 1997;19(1):33–6.CrossRefPubMed

15.

Moncrieff MD, Hamilton SA, Lamberty GH, Malata CM, Hardy DG, Macfarlane R, et al. Reconstructive options after temporal bone resection for squamous cell carcinoma. J Plast Reconstr Aesthet Surg. 2007;60(6):607–14. doi:10.1016/j.bjps.2006.11.005.CrossRefPubMed

16.

Malata CM, Tehrani H, Kumiponjera D, Hardy DG, Moffat DA. Use of anterolateral thigh and lateral arm fasciocutaneous free flaps in lateral skull base reconstruction. Ann Plast Surg. 2006;57(2):169–75. doi:10.1097/01.sap.0000218490.16921.c2. discussion 76.CrossRefPubMed

17.

Teknos TN, Nussenbaum B, Bradford CR, Prince ME, El-Kashlan H, Chepeha DB. Reconstruction of complex parotidectomy defects using the lateral arm free tissue transfer. Otolaryngol Head Neck Surg. 2003;129(3):183–91.CrossRefPubMed

18.

Kuek LB, Chuan TL. The extended lateral arm flap: a new modification. J Reconstr Microsurg. 1991;7(3):167–73. doi:10.1055/s-2007-1006775.CrossRefPubMed

19.

Sieg P, Hakim SG, Bierwolf S, Hermes D. Subcutaneous fat layer in different donor regions used for harvesting microvascular soft tissue flaps in slender and adipose patients. Int J Oral Maxillofac Surg. 2003;32(5):544–7.CrossRefPubMed

20.

Reinert S. The free revascularized lateral upper arm flap in maxillofacial reconstruction following ablative tumour surgery. J Craniomaxillofac Surg. 2000;28(2):69–73. doi:10.1054/jcms.2000.0118.CrossRefPubMed

21.

Gellrich NC, Schramm A, Hara I, Gutwald R, Duker J, Schmelzeisen R. Versatility and donor site morbidity of the lateral upper arm flap in intraoral reconstruction. Otolaryngol Head Neck Surg. 2001;124(5):549–55. doi:10.1067/mhn.2001.115522.CrossRefPubMed

22.

Depner C, Erba P, Rieger UM, Iten F, Schaefer DJ, Haug M. Donor-site morbidity of the sensate extended lateral arm flap. J Reconstr Microsurg. 2012;28(2):133–8. doi:10.1055/s-0031-1289165.CrossRefPubMed

23.

Yu AX, Chen ZG, Yu GR. Applied anatomy of distal humerus pe-riosteo-cutaneous flap pedicled with collater-alis radialis vessels. Chin J Exp Surg. 1995;12(6):368-9.

Title: Use of modified lateral upper arm free flap for reconstruction of soft tissue defect after resection of oral cancer
Authors: Xu-Dong Yang
Su-Feng Zhao
Qian Zhang
Yu-Xin Wang
Wei Li
Xiao-Wei Hong
Qin-Gang Hu
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Head & Face Medicine / Issue 1/2016
Electronic ISSN: 1746-160X
DOI: https://doi.org/10.1186/s13005-016-0105-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Use of modified lateral upper arm free flap for reconstruction of soft tissue defect after resection of oral cancer

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2016

Comparison of results of graft uptake using tragal cartilage perichondrium composite graft versus temporalis fascia in patients undergoing surgery for chronic otitis media – squamous type

Tongue volume in adults with skeletal Class III dentofacial deformities

Expression of cell adhesion molecule CD44 in mucoepidermoid carcinoma and its association with the tumor behavior

Successful treatment of multiple bilateral impactions - a case report

Oral lichen planus clinical characteristics in Italian patients: a retrospective analysis

Dentin abrasivity of various desensitizing toothpastes