Fasciocutaneous Radial Forearm Free Flap for Reconstruction of Laryngectomy Defects

Abstract

Among the numerous donor-site options for fasciocutaneous free flap in hypopharyngeal defect reconstruction, one of the most widely used is the radial forearm free flap (RFFF). Since its introduction in 1981, this technique has gained significant popularity, specifically in the reconstruction of laryngeal defects. The functional and anatomical alterations of the larynx that may result from partial or total laryngectomy are considerable in size, and a thoughtful reconstructive approach is essential in order to limit unfavorable functional outcomes as well as surgical complications and morbidity. This may be accomplished with the use of RFFF, as the cutaneous tissue utilized mimics the native pharynx more closely than other alternatives. This technique is valued for its proven reliability and pliability while also limiting donor-site morbidity, and in turn, benefits are seen in the restoration of normal laryngopharyngeal function following surgery. Although the utilization of RFFF is still prevalent in head and neck reconstruction following primary laryngectomy, an increasing use is seen following salvage laryngectomy due to more frequent initial treatment with radiation and chemotherapy. The defects in which RFFF use is primarily indicated includes neopharynx closure in which posterior strip of mucosa is present but not sufficient for primary closure or complete circumferential defects.