ANOMALIES OF FOREARM VASCULAR ANATOMY ENCOUNTERED DURING ELEVATION OFTHE RADIAL FOREARM FLAP

Background. The radial forearm flap has gained considerable popularity over the past 10 years. With the increasing number of forearm flaps b eing used in head and neck reconstruction, it is likely that anomalous forearm vascular anatomy will be encountered by more head and neck su rgeons performing this procedure. Methods. We reviewed our experience with 52 forearm flaps; four different anomalies of forearm vascular an atomy were encountered in four patients. In this article we present ea ch of our cases and discuss the incidence, preoperative diagnosis, and recommended management of these and the more common forearm vascular anomalies. Results. The anomalies encountered in our series include: o ne case of distal takeoff of the radial artery deep to the pronator te res muscle, two cases of a superficial dorsal antebrachial artery, one case of bilateral hypoplastic ulnar arteries, and one case of high ta keoff of the radial artery. Conclusions. There are a number of anomali es of forearm vascular anatomy of clinical significance to the surgeon performing these procedures. Most of these anomalies can be identifie d with a careful preoperative examination. Surgeons performing this pr ocedure should be familiar not only with the normal vascular anatomy o f the forearm flap, but also with the more common anatomic variants. F ailure to recognize or appropriately manage these anomalies of forearm vascular anatomy may result in a compromised surgical outcome.