The lateral arm flap

Reconstructive surgery after extensive tumor resection and radionecrosis in the head and neck regions continues to be a challenge for reconstructive s urgeons. Treatment of even small cancers often requires extensive surgery. The often reduced life expectancy of many of these patients, such as those with hypopharyngeal cancer, suggests a single-step method of reconstruction to provide rapid rehabilitation of swallowing, mastication, and speech. Pr ior to the use of microsurgical technique, pedicled fasciocutaneous and mus cle flaps were the workhorses for head and neck reconstruction. To reduce t he donor site morbidity and improve the quality of reconstruction, free fla ps have become the method of choice. The most popular fasciocutaneous flap for head and neck reconstruction has been the radial forearm free flap (RFF ). To reduce the donor site morbidity, however, the use of the conventional lateral arm flap (LAF) and the extended lateral arm flap (ELAF) as the fir st choice for reconstruction of large soft-tissue defects of the head and n eck, as well as in the reconstruction of noncircumferential hypopharyngeal defects, is now preferred. The purpose of this paper is to review our exper iences and formulate conclusions concerning the indications, advantages, an d disadvantages of the LAF and ELAF in head and neck reconstruction.