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Research Paper | Medical Surgical | Bangladesh | Volume 12 Issue 12, December 2023
Comparison between Anterolateral Thigh Flap and Radial Forearm Free Flap in Head-Neck Cancer Reconstruction
Dr. Md. Jahin Tareq Bhuiyan | Dr. Md. Shaharior Arafat Shawrave
Abstract: Background: The radial forearm flap (RFF) and the anterolateral thigh flap (ALT) are commonly used for the reconstruction of oral cavity soft tissue defects. The aim of the study was to assess and compare the flap survival, complications and postoperative functional outcomes of the patients after reconstruction of extensive oral cavity defects with ALT and RFF flap following cancer ablation. Patients and Methods: A retrospective study was conducted at Department of Otolaryngology- Head and Neck surgery, Dhaka Medical College Hospital, from 1st July, 2020 to July, 2022, a total of 75 patients were enrolled through non probability purposive sampling and according to the selection criteria, affected by advanced oral cavity cancer underwent microsurgical reconstruction with 23 RFF and 52 ALT procedures. The flap survival, complications and postoperative functional outcomes among these two groups were retrospectively analyzed. Results: Mean age of the patients was 54.4 (? 7.9) years in RFF group and 52.8(?6.1) years in ALT group (range= 40-75 years). Flap survival rate was 91.3% for RFF group and 86.5% for the ALT group (p=0.71). Postoperative complications in recipient site occurred in 17.4% of the RFF group and in 26.9% of the ALT group (p=0.56). In donor site morbidity, cosmesis is more impaired in RFF group (82.6%) than ALT group (53.8%) (p=0.021). Haematoma occurred only in ALT group (26.7%) (p=0.004). Patients in the RFF group reported better scores in the swallowing, chewing and speech in domains of the University of Washington-Quality of Life (UW-QOL) scale compared with those in the ALT group but statistically not significant (p >0.05). In other domains, both groups reported no difference. Similarly, RFF provided the same results in the understandability of speech, normalcy of diet and eating in public place of the Performance status Scale for Head & Neck (PSS-HN), compared to the ALT but statistically not significant (p > 0.05). Statistical analysis confirmed no significant difference between the two groups regarding the variables investigated (p>0.05). Conclusion: In our observation, ALT and RFF flap demonstrated analogous practicability and reliability for the reconstruction of oral cavity soft-tissue defects, with similar flap survival rate, donor-site complications and postoperative functional outcome.
Keywords: Head-neck reconstruction. Free flap. Radial forearm free flap. Anterolateral thigh flap
Edition: Volume 12 Issue 12, December 2023,
Pages: 1931 - 1938