TOPOGRAPHY AND ANATOMY OF THE LATERAL UPP ER ARM FREE-FLAP

An anatomic and topographic study of the lateral upper arm free flap f or the clinical use in reconstruction. Defects of the laryngopharynx a nd the oral cavity after cancer ablation are increasingly reconstructe d by free microvascular anastomosed tissue transfer. Besides the jejun um transplant we use the free radial forearm flap frequently This flap is suitable for restoring intraoral and pharyngeal integrity. Major d isadvantages are the requirement of a skin graft to obtain wound closu re and the cosmetic deformity. The lateral upper arm free flap is inte nded as alternative method for the fasciocutaneus tissue transfer. Bas ed on our dissection of ten cadavers we demonstrate the anatomy of the flap,the harvesting technique, and present data of vascular pedicle l ength, vessel calibers, and flap size. The vessel calibers of the prof und brachial artery ((X) over bar = 2,5 mm) and its terminal branch, t he posterior radial collateral artery ((X) over bar = 1,8 mm), are com parable to the radial artery. The pedicle length can be extended up to 13 cm by using a lateral approach. The subcutaneous tissue volume was 1,3 cm in average, and compared to the radial flap rather thick. Beca use of his bulky and strong fascia the lateral arm nap seems to be use ful as a fascia-fat flap in facial augmentation or as a fascia flap in soft tissue reconstruction. Disadvantageous are the difficult dissect ion technique and the loss of sensitivity on the lateral aspect of the forearm. Where a fasciocutaneous flap is indicated, we prefer the rad ial forearm flap.