O-075. Functional three-dimensional reconstruction of the oral cavity with radial forearm free flap (RFFF)

Aims: Surgical ablation of tumor in the oral cavity results in three dimensional, complicated defect. Not only to cover the defects but to preserve the proper function of the oral cavity and oropharynx, we designed the RFFF in multilobular shape and evaluated the functional results. Methods: In 35 patients, RFFF were designed in various three dimensional forms to cover the defects and restore the functions. Shapes of the flaps were oval (seven), bilobed in (15) and more than three-lobe shape in the remained cases. In six cases with subtotal resection of soft palate, double folded flaps were designed including palmaris longus tendon for the dynamics of the flap. For the functional evaluation, modified barium swallow test and speech and resonance tests were performed. Results: Flaps were successful in 33 cases (97.1%). In the evaluation of speech and swallowing function, all but four patients showed mild to moderate functional deficits and four cases showed oral residue during oral stage of the swallowing. Conclusions: Radial forearm free flap designed with three-dimensional concepts was the ideal method for the reconstruction of the oral cavity for maximal preservation of oral function after radical ablative surgery of the oral cavity.