RESULTS AFTER RESECTION OF INTRAORAL CANCER AND RECONSTRUCTION WITH THE FREE RADIAL FOREARM FLAP

Between 1989 and 1996, 47 patients with an intraoral squamous cell car cinoma underwent tumor resection and reconstruction with a free volar forearm flap. Tumor resection and neck dissection were performed by a head and neck surgeon and the free tissue transfer by a plastic surgeo n. Preoperative radiation therapy was given to 44 of 47 patients and p ostoperative radiation therapy to 2. One other patient was not irradia ted. There were 15 females and 32 males,with a mean age of 61 years. T he primary site of the cancer was the tongue in 15 cases, the floor of the mouth in 15, the tonsil in 10, the bucca in 3 and the retromolar trigone in 4 cases. The flap was harvested from the left forearm in 34 sind from the right in 13 patients. The mean operation time was 10 h (range 6-20) and the mean intraoperative bleeding was 486 mi (250-2,50 0). Forty-four of 46 flaps healed completely. Twelve revisions on 9 fr ee flaps were performed between 6 h and 6 days postoperatively. Overal l revisional surgery was done in 9 of 47 cases (19%). Two flaps could not be saved (4%). Infections/fistulas in the neck occurred in II of 4 6 cases (24%). Complete healing of the donor site occurred at a mean o f 2.5 months (1-5). Nine patients developed complications at the donor site, 3 hematomas and 6 superficial infections (19%). Twenty-seven of 47 patients are still alive (57%). The mean survival time was 49 mont hs (16-71).