A Trilobed Radial Forearm Free Flap: A Novel Approach to Oral Cavity Reconstruction

Head Neck. 2024 Dec 24. doi: 10.1002/hed.28046. Online ahead of print.

Abstract

Background: To evaluate the effectiveness of trilobed forearm flaps in repairing postoperative defects in T2 stage oral cancer patients, while minimizing the impact on the donor site.

Methods: 16 male patients with oral cancer were treated at two tertiary medical centers. Patients' demographic characteristics, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and University of Washington Quality of Life Questionnaire (UW-QoL) were recorded.

Results: Postoperatively, all flaps survived with primary closure of donor site. One patient experienced neck wound edema, which healed after re-drainage. The quality-of-life evaluation shows a UW-QoL score indicating an excellent quality of life, with the mean score of 78.86 ± 4.26 and a mean DASH score of 23.29 ± 9.89, indicating good function preservation of the donor site.

Conclusion: The trilobed forearm flap technique significantly improves the repair range for oral cancer defects while maintaining donor site integrity and is recommended for wider application.

Keywords: free flap; oral cancer; quality of life; radial forearm; trilobed flap.