64 The Radial Forearm Free Flap Versus the Nasolabial Flap in Adults Having Reconstructive Surgery for Oral Cancer: A Comparison of Quality-of-Life Outcomes

Abstract

Background The radial forearm free flap has classically been used in oral reconstructions, however, there has been research into an alternative option, the nasolabial flap. Surgical research is focussing more on quality-of-life outcomes to measure a successful recovery. Therefore, this review has a focus on QOL as well as functional outcomes. Aim To determine if there are better QOL outcomes between patients undergoing tongue reconstruction with the NLF or the RFFF. The quality and limitations of the included papers will be discussed. Method Four databases were searched using set search terms and inclusion/exclusion criteria. Fourteen final papers were assessed using a CASP checklist and a bias tool. Results Four papers lost patients to follow-up; one provided no information, and one excluded three patients from follow-up, leaving nine papers with complete follow-up data. Eight studies used subjective measurements for functional outcomes; two used objectives; three used both; and one study used objective measurements for speech, but no information was provided for swallowing. A variety of outcome measures were featured; despite this, all the papers found good functional and QOL results at follow-up. There were problems with bias throughout all the papers and several reoccurring limitations such as small sample size and the retrospective nature of all but one study. Conclusions Due to the significant amount of bias found, the low quality of literature available, and discrepancies between outcome measures, further research is needed in the form of a long-term prospective study with a larger cohort that includes some objective outcome measures.