Postoperative Outcome of Prelaminated Radial Forearm Free Flap for Soft Palate Reconstruction

One method for the reconstruction of the entire soft palate is to use prelaminated radial forearm flaps (PRFFF). In a two-step procedure the back of the flap is first epithelialized with split-skin and subsequently used for soft palate reconstruction. Limited data exist on the perioperative and postoperative course of this technique. In this study, we investigated the perioperative course and postsurgical outcomes of patients who received a PRFF for soft palate reconstruction.

All patients, who received a PRFFF at our clinics 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.

A total of 11 patients were enrolled (sex: 9 male, 2 female; age: 58 ± 14, 10/11 squamous cell carcinoma of the soft palate, 1/11 adenoid cystic carcinoma of the soft palate). Postoperative complications occurred in 6/11 patients. Three patients underwent revision surgery. One patient developed postoperatively a central pulmonary embolism leading to a prolonged intensive care unit stay. Flap viability was 100% across all cases and there was no high donor site morbidity in postoperative follow-ups.

The prelaminated radial forearm free flap allows a better physiological reconstruction of the soft palate while showing similar perioperative complication rates compared to the standard radial forearm free flap. In this case series no flap loss occurred, and functional outcomes were satisfactory.