University of Miami Miller School of Medicine, Miami, Florida, USA.
Department of Otolaryngology, University of Miami Health System and Jackson Memorial Hospital, Miami, Florida, USA.
Head Neck. 2023 Oct;45(10):E44-E48. doi: 10.1002/hed.27484. Epub 2023 Aug 17.
The radial forearm free flap (RFFF) is considered a workhorse for head and neck cancer reconstructive surgery due to its generally consistent anatomy, pliability, long pedicle, and accessible harvest location.
A 63-year-old male with trisomy 21 and recurrent midface basal cell carcinoma presented for surgical management. The patient underwent tumor resection including left infrastructure maxillectomy with ipsilateral rhinectomy. Preoperative Allen's test was normal; however, the planned osteocutaneous radial forearm free flap reconstruction was aborted intraoperatively due to aberrant vascular anatomy in the form of a diminutive radial artery branch. Reconstruction was instead performed with an anterolateral thigh free flap.
The patient recovered well in the hospital and was subsequently discharged to his care facility.
Radial artery anomalies may be present among trisomy 21 patients making reconstruction with a RFFF not feasible, and thus preoperative Doppler ultrasound to assess arterial anatomy is essential in this population.
由于桡侧前臂游离皮瓣（RFFF）的解剖结构通常一致、柔韧性好、蒂长且易于获取，因此被认为是头颈部癌症重建手术的主力皮瓣。
一名 63 岁男性，患有 21 三体，复发性中面部基底细胞癌，需要进行手术治疗。该患者接受了肿瘤切除术，包括左侧基础设施上颌骨切除术和同侧鼻切除术。术前 Allen 试验正常；然而，由于桡动脉小分支的异常血管解剖，计划进行的骨皮瓣桡侧前臂游离皮瓣重建术在术中被取消。取而代之的是使用股前外侧游离皮瓣进行重建。
患者在医院恢复良好，随后被转至他的护理机构。
21 三体患者可能存在桡动脉异常，使得使用 RFFF 进行重建不可行，因此在该人群中，术前多普勒超声评估动脉解剖结构至关重要。
