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DOI: 10.1055/s-0032-1315767
The Use of Combined Radial Forearm Cutaneous and Radial Forearm Fascial Flaps in Head and Neck Reconstruction: A Case Series
Publication History
18 January 2012
21 March 2012
Publication Date:
28 June 2012 (online)
![](https://www.thieme-connect.de/media/jrm/201208/lookinside/thumbnails/10.1055-s-0032-1315767-1.jpg)
Abstract
Introduction Reconstruction of complex head and neck cases involving bony and dural defects poses many issues. The primary aims of reconstruction are to provide a tight dural seal with good cranial support while also achieving a satisfactory cosmetic result.
Aims This study describes the use of combined radial forearm cutaneous flap and radial forearm fascial flaps for reconstruction of complex skull defects where each component is used for a distinct reconstructive purpose. The benefits of this technique are illustrated in the cases of three patients requiring reconstruction following tumor resection.
Methods The fascial component was used as a seal for dural defects. The cutaneous flap was then used to reconstruct the concomitant cutaneous defect.
Conclusion The combined use of the fascial and cutaneous components of the radial forearm flap, where each is used for a distinct reconstructive purpose, increased the reconstructive versatility of this commonly used flap. The fascial flap was a thin, pliable, and highly vascularized piece of tissue that was effectively used to provide a watertight seal for the dural defect. The simultaneous use of the cutaneous flap gave support to the bony defect while providing a good cosmetic result.
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References
- 1 Cornelius JF, George B, Kolb F. Combined use of a radial fore arm free flap for extra-intracranial bypass and for antero-lateral skull base reconstruction—a new technique and review of literature. Acta Neurochir (Wien) 2006; 148: 427-434
- 2 Winslow CP, Cook TA, Burke A, Wax MK. Total nasal reconstruction: utility of the free radial forearm fascial flap. Arch Facial Plast Surg 2003; 5: 159-163
- 3 Bondin D, Ross GL. The use of a combined radial forearm flap and radial fascial flap for layered dural lining and an orbital defect reconstruction. J Plast Reconstr Aesthet Surg 2011; 64: e167-e169
- 4 Ross GL, Ang ES, Golger A , et al. Which venous system to choose for anastomosis in head and neck reconstructions?. Ann Plast Surg 2008; 61: 396-398
- 5 Ross GL, Ang ES, Lannon D , et al. Ten-year experience of free flaps in head and neck surgery. How necessary is a second venous anastomosis?. Head Neck 2008; 30: 1086-1089
- 6 Ross GL, Ang S W EE, Lannon D , et al. A ten-year experience of multiple flaps in head and neck surgery: how successful are they?. J Reconstr Microsurg 2008; 24: 183-187
- 7 Yang GF, Chen PJ, Gao YZ , et al. Forearm free skin flap transplantation: a report of 56 cases. 1981. Br J Plast Surg 1997; 50: 162-165
- 8 Soutar DS, Scheker LR, Tanner NSB, McGregor IA. The radial forearm flap: a versatile method for intra-oral reconstruction. Br J Plast Surg 1983; 36: 1-8
- 9 Soutar DS, Tanner NSB. The radial forearm flap in the management of soft tissue injuries of the hand. Br J Plast Surg 1984; 37: 18-26
- 10 Soutar DS, McGregor IA. The radial forearm flap in intraoral reconstruction: the experience of 60 consecutive cases. Plast Reconstr Surg 1986; 78: 1-8
- 11 Lutz BS, Wei FC, Chang SC, Yang KH, Chen IH. Donor site morbidity after suprafascial elevation of the radial forearm flap: a prospective study in 95 consecutive cases. Plast Reconstr Surg 1999; 103: 132-137
- 12 Standring S. (2008) Gray's Anatomy: The Anatomical Basis of Clinical Practice 40th Edition. pp 839. Churchill Livingstone Elsevier, UK
- 13 Imola MJ, Sciarretta V, Schramm VL. Skull base reconstruction. Curr Opin Otolaryngol Head Neck Surg 2003; 11: 282-290
- 14 West CA, Towns G, Bachelor AG, Liddington MI. Reconstruction of skull base and dura using rectus abdominis muscle combined with a vascularised fascial perforator flap. J Plast Reconstr Aesthet Surg 2006; 59: 631-635
- 15 Rhemrev R, Rakhorst HA, Zuidam JM, Mureau MAM, Hovius SER, Hofer SOP. Long-term functional outcome and satisfaction after radial forearm free flap reconstructions of intraoral malignancy resections. J Plast Reconstr Aesthet Surg 2007; 60: 588-592