Lateral arm flap in oral cavity reconstruction A. Dean, F. Alamillos, J. J. Ruiz, A. Redondo, J. Torres, G. Barrios, J. A. Garcia

Revista Española de Cirugía Oral y Maxilofacial 2008: 30: 246–254 The purpose of this prospective study was to evaluate the advantages and disadvantages of the lateral arm free flap in reconstruction of the oral cavity in 10 patients. In all cases, primary reconstruction with this type of flap was carried out following resection of oral squamous cell carcinomas. Primary tumours were located on the lateral border of tongue (five cases), floor of mouth (three cases), cheek mucosa (one case) and base of the tongue–pharyngeal wall (one case). Five patients were males and five were females. Their mean age was 53.6 years. The recipient vessels for the arterial anastomosis were facial artery in nine cases and superior thyroid artery in one case. Venous anastomosis was performed with the thyro-lingual-facial trunk in seven cases and to the external jugular vein in three cases. Flap viability, morbidity of the donor site, length of the pedicle, complications and functional results were evaluated.

The results of this study showed good reconstructive outcomes without any flap-related complications in nine cases, although one flap was lost at the 7th postoperative day. No severe complications related to the donor site were recorded in six cases. Only four cases showed hypoaesthesia of the forearm as a minor complication. The length of pedicle ranged from 7 to 11 cm (mean length 8.7 cm). The size of the skin island flap ranged from 5.5 × 8 to 6 × 9.5 cm. Closure of the arm defects was direct in most cases (eight cases); while in two patients required skin grafting.The authors concluded that the lateral arm flap was a useful flap for intraoral reconstruction and it showed good adaptability and provided an adequate soft tissue volume achieving good functional results concerning tongue mobility.

JULIO ACERO