The lateral arm free flap for head and neck reconstruction

Amin, Julian; Amin, Neha; Hatten, Kyle M.

doi:10.1097/moo.0000000000000644

Cited by 5 publications

(7 citation statements)

References 31 publications

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“…There are 2 major limitations of LAFF. First, it is not always available to meet the requirements for the reconstruction of oral and maxillofacial defects with a short vascular pedicle 5 . For another, the tiny diameter of the pedicle, which is normally around 1.3 mm, 4 adds more difficulties to the operation of vascular anastomosis.…”

Section: Discussionmentioning

confidence: 99%

“…First, it is not always available to meet the requirements for the reconstruction of oral and maxillofacial defects with a short vascular pedicle. 5 For another, the tiny diameter of the pedicle, which is normally around 1.3 mm, 4 adds more difficulties to the operation of vascular anastomosis. To address these dilemmas, some researchers proposed some measures to widen the clinical application of LAFF.…”

Section: Discussionmentioning

confidence: 99%

“…After decades of development, LAFF has been proven to have unique reconstructive advantages, including excellent contour and color match to facial skin, well-compartmentalized fat, donor nerves for nerve grafting, less postoperative complications, concealed scars and the ability to 2-team harvest and close the donor site without a skin graft, etc. 3,4 However, its vascular pedicle is short and minute, 5 which makes higher requirements on surgeons in terms of vascular anastomosis than other commonly used flaps and explains its limitation in clinical application. This study reports 19 cases of buccalpenetrating defects reconstruction by the double-folded LAFF at one time to achieve good outcomes.…”

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confidence: 99%

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Reconstruction of Buccal-penetrating Defects Using the Double-folded Lateral Arm Free Flap

Deng

Ding

Zhu

et al. 2023

Journal of Craniofacial Surgery

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The reconstruction of buccal-penetrating defects remains challenging. The present study aims to explore the application value of the lateral arm free flap (LAFF) on the reconstruction of buccal-penetrating defects with the hope of providing a better option for clinical practice. Nineteen patients with this kind of issue posed by either tumor resections or deformities in the craniofacial regions were recruited in this study, and LAFF was employed to reconstruct these defects by double folding and individually designing the flap. All the flaps prepared for these subjects in our study survived, and the postoperative assessment of these subjects receiving LAFF revealed that this approach to managing buccal-penetrating defects is able to achieve satisfactory results in terms of appearance and functional recovery. Therefore, our study suggests that LAFF is 1 of the promising flaps to reconstruct the buccal-penetrating defects.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Reconstruction of Buccal-penetrating Defects Using the Double-folded Lateral Arm Free Flap

Deng

Ding

Zhu

et al. 2023

Journal of Craniofacial Surgery

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“…The preparation method of the tLAFF has shortcomings, such as short vascular pedicle, thin blood vessel diameter, high requirements for anatomical flap, and high microscopy technique, thereby limiting its popularization and application ( 2 , 5 , 14 ). Kuek et al.…”

Section: Discussionmentioning

confidence: 99%

Comparison Between Modified Lateral Arm Free Flap and Traditional Lateral Arm Free Flap for the Reconstruction of Oral and Maxillofacial Soft Tissue Defects

Wang

Sun²,

Yang³

et al. 2022

Front. Oncol.

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ObjectiveThe traditional lateral arm free flap (tLAFF) has the disadvantages of short vascular pedicle, small vascular diameter, and non-perforator flap. We used a new method to prepare modified LAFF (mLAFF) and evaluate its application value in the repair of oral and maxillofacial soft tissue defects.MethodsThe anatomical features of the flap were recorded and compared between the tLAFF group and the mLAFF group. All the flaps in the modified group were perforator flaps. Statistical analysis was performed on the data using ANOVA on SPSS 22.0 statistical software package.ResultsForty-five mLAFFs were prepared as eccentric design rotation repair perforated flap, or multi-lobed or chimeric perforator flaps. Compared with the tLAFF, the vascular pedicle length of the mLAFF was increased, and the outer diameter of the anastomosis was thickened. The damage to the donor site was less. The difference was statistically significant.ConclusionThe mLAFF can effectively lengthen the vascular pedicle length and increase the anastomosis diameter. Perforator LAFFs in the repair of oral and maxillofacial defects have good application value.

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“…Published single institutional series are limited to 2 to 48 patients. 3,[12][13][14] Here, we report the largest single-institution series of patients who underwent traditional lateral arm, extended lateral arm, or lateral forearm free flaps for head and neck reconstruction. This study aims to characterize outcomes, donor-site morbidity, and complications of lateral arm flaps.…”

mentioning

confidence: 99%

Outcomes for 160 Consecutive Lateral Arm Free Flaps for Head and Neck Reconstruction

Contrera,

Hassan,

Shuck

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveExamine outcomes for lateral arm autologous tissue transfer in head and neck reconstruction.Study DesignRetrospective cohort study.SettingTertiary cancer center.MethodsAll patients who underwent traditional lateral arm, extended lateral arm, and lateral forearm flaps for head and neck reconstruction from 2012 to 2022 were assessed. Disabilities of the arm, shoulder, and hand (DASH) was measured. Factors associated with complications and enteral or mixed diet were evaluated by multivariable regression.ResultsAmong 160 patients followed for a median of 2.3 ± 2.1 years, defects were 54% oral tongue, 18% external, 9% maxilla, 8% buccal mucosa, 9% floor of mouth, and 3% pharynx. Flap types (and median pedicle lengths) were 41% traditional lateral arm (8 cm), 25% extended lateral arm (11.5 cm), and 34% lateral forearm (14 cm). All donor sites were closed primarily; 19.6% and 0% of patients had increased DASH scores 2 and 12 weeks after reconstruction. Major complications occurred in 18.1% of patients, including 6.3% reoperation, 6.9% readmission, 3.7% fistula, and 1.8% flap loss. Complications were independently associated with peripheral vascular disease (odds ratio [OR]: 5.71, 95% confidence interval [CI]: 1.5‐21.6, P = .01), pharyngeal defects (OR: 11.3, 95% CI: 1.4‐94.5, P = .025), and interposition vein grafts (OR: 3.78, 95% CI: 1.1‐13.3, P = .037).ConclusionThe lateral arm free flap was safe, versatile, and reliable for head and neck reconstruction with low donor‐site morbidity. Complications occurred in a fifth of patients and were associated with peripheral vascular disease, pharyngeal defects, and vein grafts.

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The lateral arm free flap for head and neck reconstruction

Cited by 5 publications

References 31 publications

Reconstruction of Buccal-penetrating Defects Using the Double-folded Lateral Arm Free Flap

Reconstruction of Buccal-penetrating Defects Using the Double-folded Lateral Arm Free Flap

Comparison Between Modified Lateral Arm Free Flap and Traditional Lateral Arm Free Flap for the Reconstruction of Oral and Maxillofacial Soft Tissue Defects

Outcomes for 160 Consecutive Lateral Arm Free Flaps for Head and Neck Reconstruction

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