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.