Radical ablative surgery and radial forearm free flap (RFFF) reconstruction for patients with oral or oropharyngeal cancer: postoperative outcomes and oncologic and functional results

Abstract

A total of 132 patients were enrolled in this study. There were three RFFF failures. The rate of surgical complications was 20%. The 5-year locoregional control and overall survival rates were 68% and 52%, respectively. Advanced age, high comorbidity index, elevated overall stage and tumoral involvement of the inner part of the cheek were correlated with a lower overall survival rate. A good functional result was obtained for oral diet, speech, mouth opening and aesthetic outcome in 87%, 80%, 86% and 88% of the patients, respectively. High comorbidity index, large flap surface, radiotherapy and tumoral involvement of the mobile tongue were significant predictors of poorer functional or aesthetic outcomes.

A 10-year retrospective study of free anterolateral thigh flap application in 872 head and neck tumour cases

“…Flaps such as the free radial forearm flap and pectoralis major myocutaneous flap have their different advantages in reconstructing head and neck defects; however, several disadvantages, including donor site morbidity and aesthetic requirements, limit their application. 5,[12][13][14] In recent years, the application of ALT flaps has increased dramatically. These flaps can be used to reconstruct many types of body defect because they can be designed to meet various demands in reconstruction, especially in the head and neck region.…”

Ablative surgery and free flap reconstruction for elderly patients with oral or oropharyngeal cancer: Oncologic and functional outcomes

“…Reconstruction of complex defects following extensive ablative surgery in patients with oral or oropharyngeal cancer is one of its main indications [3,4]. Currently, the population is aging, logically resulting in increasing numbers of older patients requiring microvascular reconstruction [5].…”

Antibiotic Use after Free Tissue Reconstruction of Head and Neck Defects: Short Course vs. Long Course

“…Compared with local flap and regional flaps, free tissue offers clear advantages, including a robust blood supply, multiple potential donor sites, and the possibility of a large supply of tissue [2]. These advantages, together with the improvement in surgical techniques and instrumentation, has pushed success rates to greater than 95% [2][3][4][5][6], making free flap reconstruction the first choice in addressing defects in the head and neck.…”

“…These data suggest that: (1) Antibiotic prophylaxis reduced infection rates [12][13][14]; (2) beta-lactam antibiotics are appropriate first-line agents, with clindamycin reserved for patients with beta-lactam allergies [12][13][14][15][16][17][18][19]; and (3) prolonged courses of antibiotics do not generally result in greater reduction of infection rates. [5,[20][21][22]. However, all these studies either excluded patients receiving free flaps or had only a small number of patients having free flaps.…”