Versatility of the Radial Forearm Free Flap in Head and Neck Reconstruction. A Study of 58 Cases

Radial forearm free flap and a freka-trelumina tube for management of a refractory pharyngocutaneous fistula: A case report

“…5 In PCF reconstruction, classical regional and free flaps have been increasingly replaced by the supraclavicular artery island flap, due to limitations such as bulking, long operative time, and donor site morbidity. 2,6 However, donor site selection depends on multiple factors such as body habitus, neck status, defect size, vascular status of the neck, technical skills of the surgeon, and available resources. 7 Considering that the PMMF is a reliable and suitable option for debilitated patients due to ease of harvest and low donor site morbidity, 6 it was employed for primary PCF reconstruction following radical excision of the hypopharyngeal carcinoma in our patient.…”

“…5 In PCF reconstruction, classical regional and free flaps have been increasingly replaced by the supraclavicular artery island flap, due to limitations such as bulking, long operative time, and donor site morbidity. 2,6 However, donor site selection depends on multiple factors such as body habitus, neck status, defect size, vascular status of the neck, technical skills of the surgeon, and available resources. 7…”

“…Supraclavicular artery island flap is not practicable according to the patient's neck condition. 7 Previous literature reported RFFFs, as a versatile tool for head and neck reconstructive surgeries 2 ; however, due to its association with relatively high fistula rates, it is rarely used for PCF closure is rarely used for PCF closure. Thus, a double-layer closure technique involving a RFFF and a local adjacent flap was opted for in our case to avoid PCF recurrence.…”

“…1 The radial forearm free flap (RFFF) has been considered the flap of choice in head and neck reconstruction. 2 However, salivary leak, reflux esophagitis, and malnutrition have been reported as risk factors for flap failure in PCF reconstruction. 3 The Freka-Trelumina nasojejunal tube is often placed in pancreatic disease patients for enteral feeding and gastrointestinal decompression, 4 but has gained little attention in head and neck reconstruction patients.…”