FREE FOREARM FLAP IN ORAL RECONSTRUCTION - FUNCTIONAL OUTCOME

Objective: To examine functional outcome associated with free radial f orearm flap reconstruction of oral cavity and oropharyngeal defects. D esign and Setting: Case series obtained from a head and neck clinic co nducted at a regional cancer center. Patients underwent surgery at the associated tertiary care center. Patients: Thirty consecutive patient s treated for oral and oropharyngeal malignant neoplasms staged from T 1 to T4 were studied. Subjects were assigned to five groups based on t he site and extent of their surgical resections, as specified on a res ection template. Intervention: All patients had undergone free radial fore-arm flap reconstruction of their surgical defects. Outcome Measur es: Ten factors reflecting functional properties and processes of the upper aerodigestive tract were evaluated clinically or with videofluor oscopy or both. Results: Near-normal and fair oral and oropharyngeal f unction wholly characterized the sample. Patients who underwent recons truction of unilateral tongue, floor of mouth-ventral tongue, and retr omolar trigone-buccal defects functioned well on most measures; the fu nction of patients with anterior tongue-jaw and tongue base-tonsil def ects varied. Conclusions: Functional outcome with free radial forearm flap reconstruction was favorable for three of five subgroups of oral and oropharyngeal cancer patients. Qualitatively different functional profiles emerged for subgroups based on resection site. Methodologic i ssues for research on surgical reconstruction and functional outcome i nclude the need for a meaningful, reliable system of classifying oral and oropharyngeal resections, and the development of standardized proc edures for evaluating functional outcome.