Abstract
We report the first clinical use of a free microvascular thenar flap for reconstruction
of intraoral soft tissues. In 9 patients with a recurrent oral squamous cell carcinoma
(SCC), a new primary oral SCC, or a defect of the hard palate after radiotherapy,
we covered the soft tissue defect, after resection of the tumour or local preparation,
with a microvascular thenar flap. All patients had had combined resection and irradiation
for treatment of the initial tumour. In every case the thenar flap was harvested from
the left forearm. Arteries were anastomosed to cervical arteries on either side. The
veins were anastomosed to the deep jugular or subclavian vein. Patients were followed
up clinically after 3, 6, and 12 months and radiologically every 6 months. The mean
length of the pedicle was 21 cm. The mean width of the flap was 27 mm (range 24–30) and the mean length 37 mm (range 26–49). All anastomoses worked well. All flaps healed without major complications.
A thin but stable layer of soft tissue resulted in every case. All patients were able
to wear their prostheses. Good functional and aesthetic results were seen at each
follow-up visit, and there were no signs of relapse. The microvascular thenar flap
is well-suited for reconstruction of thin layers of soft tissue in the oral cavity.
The long pedicle and hairlessness are also ideal for covering intraoral defects after
previous operations and in necks with few if any vessels. Primary wound closure is
possible in many cases.
Keywords
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Article info
Publication history
Published online: February 27, 2012
Accepted:
February 2,
2012
Identification
Copyright
© 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
