 |
The 2004 Annual Meeting (January 14-20, 2004) of OASYS_NEW |
Not yet assigned to a slot - 2:20 AM
The Role of the Ulnar Forearm Free Flap in Oromandibular Reconstruction
Gabr EM1, Elsharaky M2, Abdelkader M2, Kobayashi M1, Sundine M3, Salibian AH3, Armstrong WB3, Calvert J3, and Evans GR3. (1) Aesthetic and Plastic Surgery Institute, University of California, Irvine, UCI, Manchester Pavilion. 200 S.Manchester Ave Suite 650, Orange, CA, USA, (2) Head and Neck surgery, Alexandria university, genral surgery dapartment, faculty of medicine, Alexandria, Egypt, (3) Surgery/Plastic Surgery, University of California, Irvine Medical Center, 101 The City Drive, Bldg.55, Rm.110, Rt.81, Orange, CA, USA
Background: The ulnar forearm flap is not frequently utilized for oromandibular reconstruction. This study evaluated the usefulness of the ulnar free flap for reconstruction. Patients and Methods: A retrospective study of 32 patients was conducted. The ulnar forearm flap was combined with an osseous flap in 24 patients. Nine females and 23 males with mean age of 58.15 years comprised our study population. Squamous Cell Carcinoma was the diagnosis in 93.75%of cases (56.25% T4) of which 20% were recurrent. Functional evaluation of swallowing was based on University of Washington Questionnaire (UWQ). Results: The mean hospital stay was 9.8days. The external carotid (100%) was the recipient artery and the internal jugular (74.07%) was the main recipient vein. Overall flap survival was 96.8%. One flap was lost due to unsalvageable venous thrombosis. Major local complications were seen in 9.4% of cases and included partial flap loss, hematoma, and orocutaneous fistula. Cosmetic acceptance was rated good in 71.4% of cases. Good swallowing was found in 28.6% of patients. Conclusion: The ulnar forearm is a useful free flap in oromandibular reconstruction. It is available when the radial artery is the dominant artery of the hand. Being more hidden, it may be more cosmetically accepted. It affords pliable soft-tissue for lining and/or covering of oromandibular defects and can be used as a second choice after other free flap failure.