THE FREE RADIAL FOREARM FLAP - A RELIABLE METHOD FOR RECONSTRUCTION OF THE LARYNGOHYPOPHARYNX AFTER IN-CONTINUITY RESECTION

Between 1992 and 1996 14 patients with a squamous cell carcinoma of th e laryngohypopharynx underwent tumour resection and primary reconstruc tion with the free volar forearm flap. Tumour resection was performed by a head and neck surgeon and reconstruction by a plastic surgeon. Pr eoperative radiotherapy was given to 13 patients and postoperative rad iation to one patient. Thirteen patients were male and one patient was female, with a mean age of 66 years (range 53-79 years). The flap was harvested From the left forearm in 12 cases and from the right in two . The mean operation rime was 12 h (range 11-20 h), and the mean intra operative bleeding volume was 700 mi (range 400-1,000 mi). Twelve of 1 4 flaps survived. One flap was totally lost 3 weeks postoperatively an d another was partially lost 2 weeks after surgery. Overall revisional surgery was carried out in six patients. infections and fistulae at t he neck occurred in six of the 14 patients. Si?: of the 14 patients we re alive at follow-up. One patient died of an acute haemorrhage from a n oesophageal ulcer 2 months after surgery, one patient died of a seco nd primary oesophageal cancer and six patients developed recurrences. The mean survival time was 26 months (range 2-43 months).