Comparison of the Medial Sural Artery Perforator Flap with the Radial Forearm Flap for Head and Neck Reconstructions

2009 ◽  
Vol 124 (4) ◽  
pp. 1125-1132 ◽  
Author(s):  
Huang-Kai Kao ◽  
Kai-Ping Chang ◽  
Fu-Chan Wei ◽  
Ming-Huei Cheng
Keyword(s):  
Head And Neck ◽  
Perforator Flap ◽  
Radial Forearm Flap ◽  
Forearm Flap ◽  
Radial Forearm ◽  
Sural Artery ◽  
Artery Perforator

Hypopharyngeal, Esophageal, and Neck Reconstruction

2018 ◽  
Author(s):  
Steven B Chinn ◽  
Peirong Yu
Keyword(s):  
Perforator Flap ◽  
Ulnar Artery ◽  
Good Alternative ◽  
Radial Forearm Flap ◽  
Anterolateral Thigh Flap ◽  
Forearm Flap ◽  
Anterolateral Thigh ◽  
Pharyngoesophageal Reconstruction ◽  
Radial Forearm ◽  
Artery Perforator

Organ preservation protocols with radiotherapy have become the primary treatment for stage I to III laryngeal and hypopharyngeal carcinoma. Many pharyngoesophageal defects are the result of salvage laryngopharyngectomy following radiation failure, making reconstruction more challenging. Given the detrimental effects of radiation on wound healing, reconstruction bathed in saliva, and the frozen neck with poor recipient vessels, pharyngoesophageal reconstruction requires great attention to detail to avoid catastrophic complications. In this review, we detail the commonly used flaps for pharyngoesophageal reconstruction, including the radial forearm flap, anterolateral thigh flap, and jejunal flap. In recent years, the anterolateral thigh flap has become the optimal flap for this type of reconstruction due to its minimal donor-site morbidity and excellent functional outcomes. Use of a two-skin island anterolateral flap allows for pharyngoesophageal reconstruction with simultaneous neck resurfacing. The profundus artery perforator flap can be a good alternative to the anterolateral thigh flap, whereas the ulnar artery perforator flap may be a good alternative to the radial forearm flap in certain cases. We discuss recipient vessel selection and conclude by outlining important postoperative considerations. This review contains 23 figures, 3 tables and 39 references Key words: anterolateral thigh flap, anteromedial thigh flap, frozen neck, gastro-omental flap, hypopharynx, laryngeal cancer, perforator flaps, pharyngocutaneous fistula, pharyngoesophageal reconstruction, profundus artery perforator flap, radial forearm flap, tracheoesophageal puncture, transverse cervical vessels, ulnar artery perforator flap

A Head-to-Head Comparison of the Medial Sural Artery Perforator versus Radial Forearm Flap for Tongue Reconstruction

2020 ◽  
Author(s):  
Marcus J.M. Ng ◽  
Cindy S.L. Goh ◽  
Ngian Chye Tan ◽  
David H. Song ◽  
Adrian S.H. Ooi
Keyword(s):  
Donor Site ◽  
Functional Results ◽  
Radial Forearm Flap ◽  
Tertiary Referral Center ◽  
Forearm Flap ◽  
Radial Forearm ◽  
Tongue Reconstruction ◽  
Sural Artery ◽  
Artery Perforator ◽  
Partial Glossectomy

Abstract Background For tongue reconstruction, the radial forearm flap (RFF) is commonly used. In the last decade, the medial sural artery perforator (MSAP) flap has been successfully used with reportedly superior donor-site outcomes. Our study is the first to compare the RFF and MSAP for reconstruction of partial glossectomy defects (<50% of tongue). Methods We conducted a retrospective review of 20 patients with partial glossectomy defects reconstructed at a tertiary referral center. Patient demographics, perioperative data, and postoperative complications were analyzed. Objective measures of speech, swallowing, and subjective patient satisfaction with their donor site were recorded. Results Ten RFF and MSAP were each used, with a mean partial glossectomy defect size of 40.5 and 43.5%, respectively. The MSAP was significantly thicker (7.8 vs. 4.3 mm, p < 0.05) with a longer harvest time (122.5 vs. 75.0 minutes, p < 0.05). There were no cases of free flap failure. Donor-site healing times were comparable, but the MSAP group experienced significantly less donor-site complications (n = 1 vs. n = 7, p < 0.05). Functional outcomes were comparable with 13 patients achieving normal speech and diet after 3 months (MSAP = 6 vs. RFF = 7, p = 1.00). All patients were satisfied with their donor-site outcome with the MSAP group having a marginally higher score. Conclusion Both flaps are good options for partial glossectomy reconstruction. Though more challenging to harvest, the MSAP gives comparable functional results and has become our first reconstructive option given its superior donor-site outcomes.

Hypopharyngeal, Esophageal, and Neck Reconstruction

2018 ◽  
Author(s):  
Steven B Chinn
Keyword(s):  
Perforator Flap ◽  
Ulnar Artery ◽  
Good Alternative ◽  
Radial Forearm Flap ◽  
Anterolateral Thigh Flap ◽  
Forearm Flap ◽  
Anterolateral Thigh ◽  
Pharyngoesophageal Reconstruction ◽  
Radial Forearm ◽  
Artery Perforator

Organ preservation protocols with radiotherapy have become the primary treatment for stage I to III laryngeal and hypopharyngeal carcinoma. Many pharyngoesophageal defects are the result of salvage laryngopharyngectomy following radiation failure, making reconstruction more challenging. Given the detrimental effects of radiation on wound healing, reconstruction bathed in saliva, and the frozen neck with poor recipient vessels, pharyngoesophageal reconstruction requires great attention to detail to avoid catastrophic complications. In this review, we detail the commonly used flaps for pharyngoesophageal reconstruction, including the radial forearm flap, anterolateral thigh flap, and jejunal flap. In recent years, the anterolateral thigh flap has become the optimal flap for this type of reconstruction due to its minimal donor-site morbidity and excellent functional outcomes. Use of a two-skin island anterolateral flap allows for pharyngoesophageal reconstruction with simultaneous neck resurfacing. The profundus artery perforator flap can be a good alternative to the anterolateral thigh flap, whereas the ulnar artery perforator flap may be a good alternative to the radial forearm flap in certain cases. We discuss recipient vessel selection and conclude by outlining important postoperative considerations. This review contains 23 figures, 3 tables and 39 references Key words: anterolateral thigh flap, anteromedial thigh flap, frozen neck, gastro-omental flap, hypopharynx, laryngeal cancer, perforator flaps, pharyngocutaneous fistula, pharyngoesophageal reconstruction, profundus artery perforator flap, radial forearm flap, tracheoesophageal puncture, transverse cervical vessels, ulnar artery perforator flap

The Neurofasciocutaneous Radial Forearm Flap in Head and Neck Reconstruction

1990 ◽  
Vol 100 (2) ◽  
pp. 161???173 ◽  
Author(s):  
Mark L. Urken ◽  
Hubert Weinberg ◽  
Carlin Vickery ◽  
Hugh F. Biller
Keyword(s):  
Head And Neck ◽  
Radial Forearm Flap ◽  
Head And Neck Reconstruction ◽  
Forearm Flap ◽  
Neck Reconstruction ◽  
Radial Forearm
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