Postoperative outcome of prelaminated radial forearm free flap for soft palate reconstruction

Introduction The radial forearm free flap has proven to be a successful surgical technique for head and neck reconstruction. One method for reconstruction of the entire soft palate is to use prelaminated radial forearm free flaps. In a two-step procedure the back of the flap is first epithelialized with split skin and subsequently it is used for soft palate reconstruction. Little is known about the peri- and postoperative course of this technique.

Methods All patients, who received a prelaminated radial forearm free flap in our clinic since 2012 were identified retrospectively. The operation was carried out in two stages. The perioperative course, postoperative complications and the functional outcome were recorded by analyzing patient files and operation protocols.

Results A total of 7 patients were enrolled (sex: 6 male, 1 female; age: 53±15, 6/7 squamous cell carcinoma of the soft palate, 1/7 adenoid cystic carcinoma of the soft palate). Postoperative complication occurred in 4/7 patients. Two patients underwent revision surgery. One patient developed postoperatively central pulmonary embolism leading to a prolonged intensive care unit stay. No flap loss was observed and there was no high donor site morbidity. 3/7 patients received adjuvant radiotherapy. At follow-up visits (5-66 months) 4/7 patients showed a very good swallowing function (dysphagia 0-1°), one patient showed dysphagia II°, two patients received a PEG tube in the course.

Conclusion The prelaminated radial forearm free flap allows a better physiological reconstruction of the soft palate when showing similar perioperative complication rates compared to the standard radial forearm free flap. In this case series, no flap loss and good functional outcome were observed.

Publication History

Article published online:
12 May 2023