Rhemrev R, Rakhorst H A, Zuidam J M, Mureau M A M, Hovius S E R, Hofer S O P
Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
J Plast Reconstr Aesthet Surg. 2007;60(6):588-92. doi: 10.1016/j.bjps.2006.10.016. Epub 2007 Feb 21.
Evaluation of objective and subjective functional follow-up results of intraoral radial forearm free flap reconstructions.
A total of 149 patients had received radial forearm free flaps between January 1996 and December 2005. Seventy-two patients completed a European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35 (EORTC H&N35) in the follow-up study. Patients were divided according to location of defect (anterior or posterior) or irradiation. Thirty-nine patients with anterior positioned flaps received standardised physical examinations.
Flap survival was 99.3%. Complications were divided in early (<2 weeks; 23%) and late complications (20%). Most common complications were dehiscence or fistula, responding well to conservative treatment. Analysis of questionnaire subscales showed no statistically significant differences between anterior and posterior defects. Irradiation showed significant impairment for the ability to smell and taste. No important donor site impairment was found.
The radial forearm free flap is an adequate method for reconstructions after resection of intraoral malignancies. Subjective functional outcome seemed to be defined by adjuvant radiotherapy, patient coping and, to a lesser extent, flap bulk for anterior defects.
评估口腔内桡侧前臂游离皮瓣重建的客观和主观功能随访结果。
1996年1月至2005年12月期间，共有149例患者接受了桡侧前臂游离皮瓣移植。在随访研究中，72例患者完成了欧洲癌症研究与治疗组织生活质量问卷-H&N35（EORTC H&N35）。根据缺损部位（前部或后部）或放疗情况对患者进行分组。39例前部皮瓣患者接受了标准化体格检查。
皮瓣存活率为99.3%。并发症分为早期（<2周；23%）和晚期并发症（20%）。最常见的并发症是裂开或瘘管，保守治疗效果良好。问卷子量表分析显示，前部和后部缺损之间无统计学显著差异。放疗对嗅觉和味觉能力有显著损害。未发现供区有重要损害。
桡侧前臂游离皮瓣是口腔恶性肿瘤切除术后重建的一种合适方法。主观功能结果似乎由辅助放疗、患者应对方式以及前部缺损皮瓣体积较小程度决定。
